Abnormalities in the response of plasma arginine vasopressin during hypertonic saline infusion in patients with eating disorders

Nishita, J. Ken; Ellinwood, Everett H.; Rockwell, W. J. Kenneth; Kuhn, Cynthia M.; Hoffman, Graham W.; McCall, W. Vaughn; Manepalli, Jothika

doi:10.1016/0006-3223(89)90009-7

Cited by 24 publications

(9 citation statements)

References 43 publications

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“…Hypertonic saline infusion in both acutely malnourished and weight-restored patients with AN demonstrated suboptimal increase of AVP in the cerebrospinal fluid and plasma, or erratic or osmotically uncontrolled AVP release, which was resolved 6 months after weight restoration (Gold et al, 1983). A similar study (Nishita et al, 1989) confirmed the dysregulation between serum osmolality and plasma AVP levels, though in this case the disordered osmoregulation persisted after weight restoration. A similar study (Nishita et al, 1989) confirmed the dysregulation between serum osmolality and plasma AVP levels, though in this case the disordered osmoregulation persisted after weight restoration.…”

Section: Discussionsupporting

confidence: 53%

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Central diabetes insipidus associated with refeeding in anorexia nervosa: A case report

Rosen

Thambundit

Mehler

et al. 2019

Intl J Eating Disorders

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Anorexia nervosa (AN) has been associated with a multitude of hypothalamic pituitary abnormalities, although it is unknown which aberrations reflect disease causation and which are the consequences of severe malnutrition. Among these endocrinopathies, hypothalamic-posterior pituitary aberrations have been described, including disorders of osmoregulation. We report the case of an adolescent female with a history of severe AN, restricting subtype, treated aggressively with multiple hospitalizations. During hospitalization for severe weakness and lethargy, her course of medical stabilization was complicated by significant polyuria, ultimately diagnosed as central diabetes insipidus (DI). This is the first reported case, to our knowledge, of a severely malnourished adolescent with AN-restricting subtype developing central DI during the refeeding process for medical stabilization, thus adding to the small body of existing literature on

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Section: Discussionsupporting

confidence: 53%

“…Although dysregulation of the AVP axis has been reported in AN (Bahia, Chu, & Mehler, 2011;Evrard, Cunha, Lambert, & Devuyst, 2004;Gold, Kaye, Robertson, & Ebert, 1983;Nishita et al, 1989), we report herein the first description (to our knowledge) of an adolescent with AN presenting with DI during hospitalization for severe malnutrition.…”

mentioning

confidence: 73%

Central diabetes insipidus associated with refeeding in anorexia nervosa: A case report

Rosen

Thambundit

Mehler

et al. 2019

Intl J Eating Disorders

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“…Nevertheless, cerebral atrophy was also verified in the course of bulimia and the possible pathogenetic factor was identified as a loss of brain tissue water due to changes in vascular permeability (Krieg, Backmund, & Pirke, 1987) secondary to the marked release of vasopressin (Nishita et al, 1989). Hoffmann et al (1989b) also found significant cortical atrophy in a group of normal weight bulimic women with no previous history of anorexia nervosa or alcohol addiction which puzzled the authors.…”

Section: Discussionmentioning

confidence: 94%

A case of marked cerebellar atrophy in a woman with anorexia nervosa and cerebral atrophy and a review of the literature

Addolorato

Taranto

Capristo

et al. 1998

Int. J. Eat. Disord.

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“…The intravenous fluids administered and the initial rate of administration were based on an algorithm derived from the caloric requirements of healthy children 7 . We postulate that secretion of natriuretic peptides as a result of volume expansion associated with SIADH 22 15 , were responsible for the natriuresis, polyuria and profound hyponatraemia seen on day 3. We conclude that in the presence of normal urinary concentrating ability, decreased intensity of the PPBS may be a marker for osmotically unregulated ADH secretion. Furthermore, although the total fluid intake in the 24 hours prior to his seizures was not excessive for his size, both the intravenous and oral fluids used had a low salt content.…”

Section: Discussionmentioning

confidence: 94%

Transient Reduction in the Posterior Pituitary Bright Signal Preceding Water Intoxication in a Malnourished Child

Neville¹,

Pereira²,

Andrews³

et al. 2004

Journal of Pediatric Endocrinology and Metabolism

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We describe a 4 year-old boy with hypothalamic dysfunction and weight loss, attributed to psychosocial deprivation. Reduced intensity of the posterior pituitary bright signal (PPBS) on MRI, associated with a normal urinary concentrating ability, was documented in the 24 hours prior to the development of the syndrome of inappropriate secretion of antidiuretic hormone (ADH) and severe hyponatraemia. The PPBS was normal on MRI 2 months later, following weight gain and resolution of the other hypothalamic abnormalities. This report shows that the abnormalities of ADH associated with decreased intensity of the PPBS include increased secretion and abnormal regulation as well as ADH deficiency. The association of osmotically unregulated ADH secretion with undernutrition and stress suggests that particuar caution should be used when fluid intake in such children is not driven by thirst.

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Abnormalities in the response of plasma arginine vasopressin during hypertonic saline infusion in patients with eating disorders

Cited by 24 publications

References 43 publications

Central diabetes insipidus associated with refeeding in anorexia nervosa: A case report

Central diabetes insipidus associated with refeeding in anorexia nervosa: A case report

A case of marked cerebellar atrophy in a woman with anorexia nervosa and cerebral atrophy and a review of the literature

Transient Reduction in the Posterior Pituitary Bright Signal Preceding Water Intoxication in a Malnourished Child

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