A 10 year old boy is having polyuria, polydipsia,laboratory data showed (in mEq/lit) – Na– 154 K– 4.5 HCO3– 22 Serum osmolality – 295 Blood urea – 50 Urine specific gravity – 1.005 The likely diagnosis is –
Correct Answer: Diabetes insipidus
Description: Lets see each option one by one :
artter's syndrome :
is characterized by hypokalemia, metabolic alkalosis and normal to low blood pressure.
It can be easily ruled out as the patient is having normal potassium level.
Renal tubular acidosis :
is characterized by hyperchloremic metabolic acidosis with a normal serum anion gap.
It is ruled out as this patient is having normal bicarbonate level (Bicarbonate level is decreased in RTA). Recurrent UTI
Symptoms seen are : Fever, dysuria, frequency, urgency, suprapubic pain.
It is ruled out as the above given symptoms are not mentioned in this patient.
Hypernatremia (Na is 154) is not seen in UTI.
iabetes insipidus :
Clinical presentation of hypernatremia, polyuria, polydypsia, thin urine of low specific gravity (1.005) is suggestive of diabetes insipidus.
Category:
Pediatrics
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