For Debate: Personalized Health Care: As Exemplified by Home Sodium Measurements in a Child with Central Diabetes Insipidus and Impaired Thirst Perception

Abstract

Background: We describe a 6-year old boy with central diabetes insipidus (CDI) caused by destruction of the pituitary gland due to treatment of an optical pathway glioma. He has been treated with chemotherapy and has had several debulking operations over the past years and consequently developed central hypocortisolism, hypothyroidism and CDI. The treatment of CDI was gravely complicated by an impaired thirst perception and compulsive drinking behavior. He was frequently seen at the ER or admitted due to dysregulation of fluid balance.

Methods: In order to provide better self-reliance, home point of care testing (POCT) sodium measurement was introduced.

Results: Realizing POCT sodium measurement resulted in a significant decrease of ER visits and clinical admissions due to dysregulation of fluid balance.

Conclusion: This case is an example of personalized health care and has led to better self-reliance and quality of life.

Keywords: Central diabetes insipidus; POCT; Patient centered health care; Self-reliance; Sodium dysregulation.