Coexistencia de Diabetes Mellitus e insípida con Hidronefrosis en un niño
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Keywords

Diabetes Mellitus
Diabetes Insípida
Hidronefrosis

How to Cite

Jácome Roca, A., Martínez, A., & Borda Camacho, E. (2018). Coexistencia de Diabetes Mellitus e insípida con Hidronefrosis en un niño. Revista Colombiana De Endocrinología, Diabetes &Amp; Metabolismo, -11(2), 94–99. https://doi.org/10.53853/encr.-11.2.190

Abstract

La diabetes Mellitus (DM) y la Diabetes insípida (DI) se han asociado en 28 niños, varios de ellos hermanos; al haber atrofia óptica adicional se ha configurado un sindrome hereditario. Ocasionalmente la poliuria de la DI produce dilatación vesical e hidronefrosis. Presentamos un niño de 8 años, con 4 años de evolución de DM, muy glucolábil. Ingresó deshidratado, estuporoso e hipoglicémico. Durante el tratamiento desarrolló marcada polidipsia (se tomaba hasta sus propios orines) y poliuria de 6 a 10 litros en 24 horas con hipourodensidad a pesar de la gran glicosuria. Las glicemias variaron de 26 a 660 mg por ciento, con glicosurias hasta de 23 g/L. Los padres y 3 hermanos eran sanos. Fondo de ojo de retinopatía diabética grado II. Durante la restricción de líquidos persistió la poliuria con hipouroidensidad (1.005) y pérdida de peso: el Pitresín  I.M. disminuyo el volumen y aumentó la densidad a 1.026. Una cistouretrografía mostró gran capacidad vesical (450 cc) y reflujo vesical-ureteral; la urografía mostró dilatación del tracto superior, hidronefrosis que fue confirmada por la biopsia renal. La función renal era normal. Convulsionó varias veces e hizo cambios de conducta por hipoglicemias. Se continuó el tratamiento con NPH, dieta y Pitresín, buscando obtener glicemias intermedias.

SUMMARY

Coexistence of Diabetes Mellitus and insipidus with hidronephrosis in a boy

Diabetes Mellitus (DM) and diabetes insipidus (DI) have been found in association in 28 children, some of them being brothers; a hereditary syndrome may also include optic atrophy. Ocasionally, DI polyuria produces bladder dilatation and hydronephrosis. We report the case of a boy, age 8 with brittle DM progressing through 4 years. He was dehydrated, stuporous and hypoglycemic on admission. While on treatment he developed marked polydipsia (he was drinking even his own urine) and polyuria of 6 to 10 liters in 24 hours, with low urine density in spite of large glycosuria (up to 23 g/L). Bood sugars ranged between 26 and 660 mg per cent. Parents and three brothers were living and well. Fundoscopic examination revealed a grade II diabetic retinopathy. During a fluid deprivation test, polyuria with low density (1005) persistent, and patiend lost weight; I.M. Pitressin Tannate oil decreased urine output and raised density to 1026. A Cystourethrography showed a large capacity (450 cc) with vesico-ureteral reflux; intravenous pyelography showed dilation of upper urinary tract, hidronefrosis that was confirmed by kidney biopsy, kidney function was normal; he had grand mal seizures and changes in behavior, due to hypoglicemic attacks, several times. Treatment based on die, NPH insulin and Pitressin was continued, trying to obtain acceptable bloodsugar levels.

Este trabajo fue presentado en el V Congreso Colombiano de Medicina Interna. Cali, Noviembre de 1978.

https://doi.org/10.53853/encr.-11.2.190
PDF (Español (España))

References

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