Three-phase course of central diabetes insipidus in a child after removal of craniopharyngioma: a clinical case

Description of the clinical case. A description of the three-phase course of CDI that developed in a child after neurosurgical removal of a giant endosuprasellar craniopharyngioma is presented. Determining the phase of the process was based on indicators of water balance, blood serum electrolytes and osmolality, urine osmolality. During the first and third phases, normo- and hypernatremia (140-153 mmol/l) with simultaneous polyuria and polydipsia was noted; the second phase was characterized by hyponatremia (132-134 mmol/l), high-normal urine osmolality (790-1190 mOsm/kg), oliguria and lack of thirst. During the first and third phases, substitution therapy with desmopressin preparations was carried out with a free drinking regimen. During the second phase, fluid intake was sharply limited in combination with dietary salt supplementation (3-5 g/day) and desmopressin withdrawal. Conclusion. The course of diabetes insipidus after neurosurgical removal of the CSR tumor requires careful monitoring in the postoperative period. Timely detection of the three-phase course of CND and a differentiated approach to the tactics of managing a child in each of the phases make it possible to avoid significant excursion in the blood electrolyte levels up to the development of life-threatening conditions.

central diabetes insipidus, three-phase course, craniopharyngioma