Abstract

Central diabetes Insipidus (CDI) represents a rare disease entity in childhood. About 20 – 50% of all cases in children are idiopathic. Early recognition and diagnosis is crucial to successful management. This is the first report of CDI in an infant in Nigeria.

Case report: We report a case of central diabetes insipidus in a 7 month old female infant who presented at the University College Hospital, Ibadan with polydipsia, polyuria and weight loss with a urine specific gravity of 1.005 and normal blood sugar. There was a history of treatment of hypovolemic shock at the referral hospital but patient was moderately dehydrated at presentation at our hospital. The diagnosis was confirmed by a plasmaosmolality of 307mOsmol/L, urine osmolality of 395mOsmol/L in the presence of dehydration and hypernatremia of 150mmol/l. A significant correction of polyuria was also demonstrated with intravenous administration of desmopressin. The radiographic evidence of an absent posterior pituitary bright spot on MRI was demonstrated in the patient.

Conclusion: Central diabetes Insipidus occurs in Nigerian children and responds well to desmopressin. We therefore recommend that this diagnosis must be considered in all patients presenting with a triad of polyuria, polydipsia and euglycemia.