原创力文档rare neonatal diabetes insipidus and associated late risks case report罕见的病例报告新生儿尿崩症和相关的后期风险.pdfVIP
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rare neonatal diabetes insipidus and associated late risks case report罕见的病例报告新生儿尿崩症和相关的后期风险
Rivas-Crespo et al. BMC Pediatrics 2012, 12:56
/1471-2431/12/56
CASE REPORT Open Access
Rare neonatal diabetes insipidus and associated
late risks: Case report
Maximiliano Francisco Rivas-Crespo1*, Lorena Miñones-Suárez1 and Susana Serrano G-Gallarza2
Abstract
Background: Most cases of neonatal central diabetes insipidus are caused by an injury, which often results in other
handicaps in the patient. The infant’s prognosis will be determined by his or her own early age and disability as well as
by the physician’s skill. However, the rarity of this condition prevents the acquisition of personal experience dealing with
it.
Case Presentation: A neonatal hemorrhagic stroke, caused by an aortic coarctation, caused right lower limb paresis,
swallowing disability, and central diabetes insipidus in a term infant. The scant oral intake, as a consequence of his
disability, caused progressive undernutrition which closed a vicious circle, delaying his development and his ability to
overcome the swallowing handicap. On the other hand, nasal desmopressin absorption was blocked by several common
colds, resulting in brain bleeding because of severe dehydration. This even greater brain damage hampered the
improvement of swallowing, closing a second harmful circle. Moreover, a devastating central myelinolysis with
quadriplegia, caused by an uncontrolled intravenous infusion, consummated a pernicious sequence, possibly unreported.
Conclusions: The child’s overall development advanced rapidly when his nutrition was improved by gastrostomy: This
was a key effect of nutrition on his highly sensitive neurodevelopment. Besides, this case shows potential risks related to
intranasal desmopressin treatment in young children.
Keywords: At term newborn, Infant, Coarctation of the aorta, Neonatal intraventricular hemorrhag
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