小児尿崩症の追跡的研究

DIABETES INSIPIDUS IN CHILDREN : LONG-TERM FOLLOW-UP STUDY

I．はじめに

　Vasopressin感受性尿崩症が脳腫瘍の初発症状として出現することは周知である。しかし，一般には尿崩症の原因としては特発性のものが最も多いとされている。昭和50年，厚生省研究班「小児内分泌疾患の臨床的研究」が実施した小児内分泌疾患の実態に関する研究報^12）においても，特発性のものは器質性のそれを上まわつている。

　しかし，尿崩症の症例を長期観察すると，脳腫瘍の顕現してくるものがかなり多いことに気づかれる。

A follow-up study was carried out on 12 children with vasopressin sensitive diabetes insipidus.

1) Nine cases (75%) of 12 were finally diagnosed as having brain tumor in later course. There were 3 cases (25%) who could not be decided as having brain tumor during the follow-up period of more than 6 years.

2) There was one case who developed the overt signs of brain tumor 9 years after the onset of diabetes insipidus. Therefore, it seems necessary to follow-up cases with diabetes insipidus for at least 10 years before determining it as idiopathic type.

3) In cases with diabetes insipidus due to brain tumor, associated growth retardation, autonomic symptoms, behavior disorder, endocrine dysfunction and metabolic dysfunction were frequently obse-rved. In the case where these symptoms become aggravated with lapse of time, these findings should be taken seriously as indicating brain tumor.

4) In the case showing either anterior or posterior focal slow waves in the EEG, if such focal slow waves aggravate with age, the findings should be considered as indicative of Drain tumor.

5) We would like toemphasize the significance of brain tumor as the underlying pathology of child-hood diabetes insipidus.