A case of abnormal thirst

1973 BMJ (Clinical Research Edition)  
Cliical History PROFESSOR RUSSELL FRASER (1): We are going to consider a 12-year-old boy (fig. la) who came to this hospital in February 1971 because of abnormal behaviour, poor growth, and refusal of both food and liquids. When he was 10 years and 4 months old he had a period of polyuria and polydipsia with about 10 pints (5-7 1.) intake per day, for which he was admitted to another hospital, where diabetes insipidus was diagnosed. He had haemo-concentrated serum (Na 147 mN). After 8 hours'
more » ... . After 8 hours' water deprivation he lost 4 lb (1-8 kg) while when he was given pitressin tannate he produced concentrated urine and lost his thirst. During the subsequent year he grew only I in (1-25 cm) and he began to develop behaviour problems: he could not concentrate on his lessons, and was generally very distractable. His school progress was poor and there were several problems involving stealing and other behaviour disorders. Then a curious change in his attitude towards water occurred: he lost his severe thirst, developed an aversion to fluids, and had to be encouraged to drink. He was admitted to the Radcliffe Infirmary in Oxford, where he was found to be dehydrated, drowsy, and stuporose, but showed no localizing neurological signs. Full examination was done there, including an air encephalogram, and perhaps Dr. Doyle will show us the Oxford x-ray films.
doi:10.1136/bmj.3.5873.214 fatcat:l52pbby7nzgsle5cv74ts2dbea