Differential Diagnosis for Bed-Wetting in a 5-Year-Old Girl
- Single Most Likely Diagnosis
- Diabetes Mellitus: The patient's symptoms of polyuria (frequent urination), polydipsia (increased thirst), and nocturnal enuresis (bed-wetting) are classic signs of diabetes mellitus. The recent weight loss and dry mucous membranes also support this diagnosis.
- Other Likely Diagnoses
- Urinary Tract Infection (UTI): Although the patient does not have dysuria or hesitancy, a UTI can still cause frequent urination and accidents.
- Constipation: Constipation can cause urinary incontinence, and the patient's recent change in bowel habits is not mentioned.
- Stress or Anxiety: The recent move to a new house and the birth of a new sibling can cause significant stress, leading to secondary enuresis.
- Do Not Miss Diagnoses
- Diabetes Insipidus: Although less common than diabetes mellitus, diabetes insipidus can cause similar symptoms of polyuria and polydipsia.
- Renal Failure: Chronic kidney disease can cause polyuria, fatigue, and weight loss.
- Spinal Cord Lesions or Neurological Disorders: Although rare, spinal cord lesions or neurological disorders can cause urinary incontinence and should not be missed.
- Rare Diagnoses
- Hyperthyroidism: Hyperthyroidism can cause increased urine production and frequency.
- Castrate-Resistant Neuroblastoma or Other Rare Tumors: Certain rare tumors can cause urinary frequency and incontinence.
- Chronic Kidney Disease due to Other Causes (e.g., reflux nephropathy): Other causes of chronic kidney disease can also lead to polyuria and fatigue.