Analysis Of The Central Diabetes Insipidus

ObjectiveTo analyze the correlation among the etiology, the clinical manifestations and the anterior pituitary functions of central diabetes insipidus (CDI), assess the result of the fluid deprivation-vasopressin test, observe the pituitary magnetic resonance imaging (MRI) of idiopathic central diabetes insipidus (IDI), evaluate the effect of arginine vasopressin (AVP) in the treatment of central diabetes insipidus.Subjects117cases of central diabetes insipidus admitted to the Endocrinology department of Tongji hospital between January, 2003 and January, 2010.MethodsRetrospective analysis on the medical records of all these patients,including clinical manifestation, laboratory data, etiology and therapy. Evaluate the results of urinary output, density, urinary osmolality and blood electrolytes,anterior pituitary functions (ACTH, Cortisol,thyroid hormone and sex hormone), pituitary imageology(pituitary MRI or head CT), fluid deprivation-vasopressin test, all the treatment and effect.ResultsMost of the cases among children and adolescents fell ill at the age of 12~16 years, while most of the adults fell ill at the age of 35~40 years.The causes of central diabetes insipidus in this study included idiopathic 70.9%, neoplasm 14.5%, head trauma 7.7%, postoperation 4.3%and intracranial infections 2.6% .The idiopathic in children and adolescents are less than the adults, but neoplasm in children and adolescents are more. Urinary output, urinary density and osmolality were items of the first choice to diagnose diabetes insipidus (DI). The fluid deprivation-vasopressin test is the useful method to diagnose diabetes insipidus. Pituitary MRI is helpful for the diagnosis of the basic cause. Pituitary MRI showed the absence of high signal normally seen in posterior lobe and thickened pituitary stalk are most in the central diabetes insipidus. Arginine vasopressin (AVP) had accurate efficacy in the treatment of idiopathic central diabetes insipidus.ConclusionsIdiopathic central diabetes insipidus occupied the most cause. Pituitary MRI is helpful for the diagnosis of the basic cause. The fluid deprivation-vasopressin test is the useful method to diagnose diabetes insipidus. Regular clinical follow-up with serial brain MRI and anterior pituitary functions are necessary for the idiopathic central diabetes insipidus.