Sir.—The article by Greger et al1 describing 73 children with central diabetes insipidus (DI) over 22 years failed to emphasize that one of the most common causes of DI during childhood is brain death. Outwater and I2 reported the development of DI in 14 of 16 children who met criteria for brain death over a two-year period. This is probably due to inability to produce or transport vasopressin in the absence of any cerebral circulation.
Most of these children probably do not come to the attention of endocrinologists. Nevertheless, it is important for pediatricians to be alert to the development of DI in children with brain death if vital organs are to be preserved for transplantation.