Deficiency of arginine vasopressin in children - diagnostic and therapeutic approaches to improve patients' quality of life based on a 25-year, single-centre retrospective analysis.

Abstract

Introduction: Arginine vasopressin deficiency (AVD) encompasses disorders marked by polyuria, polydipsia, hypernatraemia, and hyperosmolality. This study aims to refine diagnostic and therapeutic strategies to enhance the quality of life for AVD patients.

Material and methods: We conducted a 25-year retrospective analysis of imaging, hormonal, auxological, and densitometric data from 31 children diagnosed with AVD at the Department of Paediatric and Adolescent Endocrinology, Children's Hospital in Krakow between 1998 and 2023.

Results: The average duration from the onset of symptoms to AVD diagnosis was 10 months (range: 1-86 months), and from diagnosis to aetiology determination was 14 months (range: 0-86 months). Causes of AVD included idiopathic (9.7%), central nervous system tumours (61%), pituitary adenoma (5.2%), central nervous system malformations (9.7%), head trauma (6.5%), haemorrhage or hydrocephalus (6.5%), familial AVD (3.2%), and inflammatory central nervous system conditions (3.2%). Growth retardation was observed in 48.4% of cases, obesity in 41.9%, hormonal disorders in 61.3%, and low bone mass in 16.1%.

Conclusions: We developed a diagnostic and metabolic evaluation scheme for AVD that facilitates earlier aetiology identification and helps prevent hormonal, metabolic, and bone complications. This approach is crucial for improving the quality of life in both developmental and adult stages for these patients.