Diabetes Insipidus in Children
Diabetes insipidus in children is a rare disease that inhibits the kidneys' ability to process fluids. The amount of fluid processed by kidneys is influenced by the ability to process the anti-diuretic hormone (ADH), also called vasopressin. There are two types of diabetes insipidus in children: central and nephrogenic. Even though the name implies diabetes, it is not at all related to type 1 or type 2 diabetes. The only similarity to type 1 or type 2 diabetes is the symptom of extreme thirst and frequent urination.
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Rates of Diabetes Insipidus in Children
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Diabetes insipidus affects only about one in 25,000 people in the United States, according to the Mayo Clinic. The mortality rate of diabetes insipidus is very small in adults. However, the complication of extreme dehydration in children can be severe and life-threatening, so it is important to seek proper medical treatment if diabetes insipidus is suspected.
Symptoms
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The symptoms of diabetes insipidus closely mimic the symptoms of type 1 diabetes, hence the name. The major symptom is extreme, unquenchable thirst. This is closely followed by frequent urination. Since the kidneys are unable to properly process water, the urine output is equal to the amount of fluids ingested. Children with diabetes insipidus can also experience unexplained fussiness and crying, fever, vomiting, diarrhea, dry skin with cold hands and feet, delayed growth and weight loss.
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Central diabetes insipidus
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Central diabetes insipidus can be permanent or reversible, depending on the root cause. It is usually caused by damage to the pituitary gland or the hypothalamus. This can occur through surgery, a tumor, a head injury or illness, such as meningitis. The damage disrupts how the body produces, stores and releases ADH.
Nephrogenic diabetes insipidus
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Nephrogenic diabetes insipidus in children is usually a genetic defect. It occurs when the kidneys' tubules renders the child's kidneys unable to respond to ADH. The structure of the kidneys include tubules that help the kidneys absorb and excrete water. When they do not properly react to the ADH, severe thirst and frequent urination occur.
Complications
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The two major complications of diabetes insipidus are dehydration and electrolyte imbalance. Symptoms of dehydration are dry skin, dry mucous membranes, sunken eyes, fever, rapid heart rate, and weight loss. Fatigue, lethargy, frequent headaches, irritability and muscle pains characterize electrolyte imbalance. It is imperative to seek prompt medical advice when symptoms of dehydration are present in children.
Treatment
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Treatment depends on the type of diabetes insipidus. A daily dose of vasopressin, as either a nose spray or a pill, is used to treat central diabetes insipidus since damage usually results in the lack of production of ADH. If it is hereditary nephrogenic diabetes insipidus, treatment involves reducing salt intake, as well as the medication hydrochlorothiazide to help reduce urine output. It is also important to match fluid intake to urine output.
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