Diabetes insípida: generalidades y diagnóstico en pacientes pediátricos

  • Juan Carlos Velásquez Uribe Universidad de Antioquia
  • Germán Campuzano Maya Laboratorio Clínico Hematológico
  • Juan Manuel Alfaro Velásquez Universidad de Antioquia
Palabras clave: diabetes insípida, diabetes insípida neurogénica, diabetes insípida nefrogénica, arginina vasopresina, concentración osmolar, poliuria.

Resumen

La diabetes insípida es una enfermedad caracterizada por la incapacidad parcial o total para concentrar la orina, debido a una deficiencia en la secreción de vasopresina (diabetes insípida central), resistencia en la acción de la misma (diabetes insípida nefrogénica) o a ingesta excesiva de agua (polidipsia primaria). Las principales manifestaciones son polidipsia, poliuria y nicturia; la diabetes insípida central tiene un inicio repentino, mientras que la nefrogénica tiene un inicio más gradual. Gracias a los avances en laboratorio clínico, imaginología y biología molecular, ha mejorado el diagnóstico etiológico de la diabetes insípida, pasando de 50% de casos idiopáticos a solo entre 10% y 20%, de forma que se ha logrado un tratamiento más oportuno, con la consecuente reducción del riesgo de secuelas. En este sentido, es de especial importancia descartar causas secundarias, tales como medicamentos o desórdenes metabólicos en la diabetes insípida nefrogénica y tumores cerebrales, traumatismos craneoencefálicos, enfermedades infiltrativas, enfermedades autoinmunes o infecciones de sistema nervioso central en el caso de la diabetes insípida central. En cuanto al tratamiento, para la diabetes insípida central se recomienda el uso de desmopresina, análogo sintético de la vasopresina, y para la nefrogénica aporte de agua, limitación a la ingesta de sal y el consumo de diuréticos y antinflamatorios no esteroideos. En este artículo de revisión se describirá la fisiopatología, manifestaciones clínicas, diagnóstico y tratamiento de la diabetes insípida en la edad pediátrica.

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Biografía del autor/a

Juan Carlos Velásquez Uribe, Universidad de Antioquia

Médico Pediatra, residente Endocrinología Pediátrica, Universidad de Antioquia. Medellín, Colombia.

Germán Campuzano Maya , Laboratorio Clínico Hematológico

Médico especialista en Hematología y Patología Clínica. Docente, Ad Honorem, Facultad de Medicina, Universidad de Antioquia. Médico Director, Laboratorio Clínico Hematológico. Medellín, Colombia.

Juan Manuel Alfaro Velásquez, Universidad de Antioquia

Médico Pediatra Endocrinólogo, Profesor titular Universidad de Antioquia. Medellín, Colombia.

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Cómo citar
1.
Velásquez Uribe JC, Campuzano Maya G, Alfaro Velásquez JM. Diabetes insípida: generalidades y diagnóstico en pacientes pediátricos. Med. Lab. [Internet]. 1 de julio de 2013 [citado 17 de octubre de 2021];19(7-8):353-79. Disponible en: https://medicinaylaboratorio.com/index.php/myl/article/view/235
Publicado
2013-07-01
Sección
Endocrinología

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