Langerhans cell histiocytosis presenting as isolated central diabetes insipidus in a 2-year-old child: a rare manifestation of rare disease

Central diabetes insipidus, though uncommon in children, has varied causes, the commonest ones being genetic mutations, infiltrative disorders, infections. Isolated central diabetes insipidus is not one of the often encountered conditions in the pediatric practice. Here we report a case of 2 ' years old female child who presented to us following history of polyuria for 2 months, who was confirmed to have central diabetes insipidus which was later evaluated to be secondary to Langerhans cell histiocytosis. Magnetic resonance imaging (MRI) and histopathological studies further helped in confirmation of the diagnosis. Langerhans cell histiocytosis is a rare, multifarious, and underdiagnosed hematologic disease in which isolated diabetes insipidus can be the sole presenting feature before other manifestations. Hence, this diagnosis could strongly be considered in the work up of central diabetes insipidus in children.

How safe are our children in our own homes? accidental ingestion in children: a 6 year retrospective study from a tertiary care centre

Background: According to the World Health statistics, in 2016 more than 100000 deaths were caused due to unintentional poisonings. Children are vulnerable due to their smaller body surface area, an inherent behaviour of negation, curiosity in exploring their surroundings, their initial phallic stage where they tend to put any objects they come across into their mouth.Methods: This study is a hospital based retrospective observational study where the records of all the children admitted due to poisoning, accidental or intentional from June 2012 to November 2018 were reviewed. All the children admitted due to food poisoning and idiosyncratic drug reactions were excluded from the study.Results: A total of 203 cases of accidental ingestion were admitted during the study period, of which the majority of the patients were male children. The age group varied from 5 months to 14 years. Majority of the accidental ingestions were due to kerosene (108), followed by insecticides (25) and cleaning agents (20).Conclusions: Poisoning in young children is unintentional and accidental; hence the introduction of safe child resistant containers should be encouraged in storing harmful chemicals. Knowledge about the chemicals, awareness about their hazardous effects and education of the care givers about safe storage would be the first step in the prevention of accidental ingestion. Establishment of a reporting system from all the health care centres and establishment of poison information system at all the levels is the need of the hour.