Abstract
Psychogenic water drinking has been reported only in older children and adults. We shall report successful management of three young children with psychogenic water drinking. One infant, 2½ mo. old was extremely irritable unless the oral fluid intake ranged from 1200-2100 ml/day. Urine Osm. was 42 mOsm/L and serum Osm. was 272 mOsm/L. Urine output was 1705 ml/day. Serum Na was 132 mEq/L;serum K 5.2 mEq/L;BUN 8 mg%;serum Ca 10.5 mg% and 24 hr. Ca excretion less than 3 mg/kg/24 hr. During the water loading portion of a modified Carter Robbin's Test, CH2O was +10.9 ml/min/1.73m2. CH2O fell to -0.37 ml/min/1.73m2 when 3% NaCl was infused. A 6 mo. old and a 2½ yr. old had polydipsia and polyuria without dehydration and were able, after overnight water deprivation,to concentrate their urines. An abnormal maternal child relationship in two patients, and a prescribed fluid diet in the third had led to excessive water ingestion through inappropriate maternal responses. Appropriate psychological advice coupled with restriction of fluid to estimated insensible water loss plus 25-35% of expected normal urine output resulted in a “cure” in all patients within 6 weeks.
In summary: Psychogenic water drinking in the very young appears to be a real entity and responds to parental counseling along with carefully monitored water restriction.
Supported in part by NIH grant RR-75, RR-5624.
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Linshaw, M., Hipp, T., Gruskin, A. et al. INFANTILE PSYCHOGENIC WATER DRINKING. Pediatr Res 8, 344 (1974). https://doi.org/10.1203/00006450-197404000-00025
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DOI: https://doi.org/10.1203/00006450-197404000-00025