NEUROGENIC DIABETES-INSIPIDUS IN CHILDREN WITH HYPOXIC ENCEPHALOPATHY- 6 NEW CASES AND A REVIEW OF THE LITERATURE

Hypoxic encephalopathy is rarely mentioned as a cause of neurogenic di abetes insipidus (DI) in children. We here report six cases of DI whic h occurred after severe hypoxic/ischaemic brain damage and include a r eview of the literature on 28 paediatric cases of neurogenic DI due so lely to severe hypoxia/ischaemia. Airway obstruction, haemorrhagic sho ck and sudden infant death syndrome are the three major causes of hypo xia/ischaemia. The ages (25/28) ranged from 0.03 to 18 years (mean 7.2 7 years, median 5 years). The intervals between the hypoxic insult and the onset of DI (23/28) ranged from 0.08 days (2 h) to 13 days (mean 4.07 days, median 3.5 days). Linear regression analysis revealed no si gnificant correlation between the age and the interval. Nineteen cases (82.6%) developed DI within 6 days after the hypoxic/ischaemic insult . Only two neonates survived with developmental delay, The remaining 2 6 cases died. Conclusion Neurogenic DI can be hypoxia/ischaemia and is sign of severe brain damage in children with hypoxic encephalopathy. It is important to recognize:this potential sequel by regularly monito ring intake and output, plasma sodium level, and urine specific gravit y.