Diabetes Insipidus

Saborío, Pablo; Tipton, Gary; Chan, James C.M.

doi:10.1542/pir.21.4.122

Cited by 11 publications

(4 citation statements)

References 4 publications

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“…Unfortunately, to this date, our understanding of the reasons for development of postoperative DI is limited. 26 We know disruption to AVP production is due to interruption of the communication between magnocellular cell bodies and nerve terminals of posterior pituitary. 14,27,28 Degeneration in AVPproducing cells furthermore increases incidence of permanent DI.…”

Section: Rationalementioning

confidence: 99%

Correlation of Pituitary Descent and Diabetes Insipidus After Transsphenoidal Pituitary Macroadenoma Resection

Gooderham

Akagami

et al. 2023

Neurosurgery

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BACKGROUND:Endoscopic transsphenoidal surgery remains the technique of choice for resection of pituitary adenoma. Postoperative diabetes insipidus (DI) is most often transient and observed in 1.6% to 34% of patients, whereas permanent DI has been reported in 0% to 2.7% of patients. The proposed mechanism was the transduction of traction forces exerted by the surgeon on the descended diaphragma sellae and through the pituitary stalk.OBJECTIVE:To quantify and correlate the degree of pituitary gland descent with postoperative DI.METHODS:Of 374 patients who underwent transsphenoidal resection of a pituitary adenoma between 2010 and 2020 at our institution, we report a cohort of 30 patients (Group A) DI. We also report a matched cohort by tumor volume of 30 patients who did not develop DI (Group B). We quantified the tension on the pituitary stalk by calculating pituitary descent interval (PDI) by comparing preoperative and postoperative position of the pituitary gland and using Pythagoras' formula where PDI=CC2+AP2, with craniocaudal (CC) and anterior–posterior (AP) representing measurements of pituitary translation in respective directions after resection.RESULTS:Patients who developed DI had significantly greater pituitary gland translations in the craniocaudal (23.0 vs 16.3 mm, P = .0015) and anteroposterior (2.4 vs 1.5 mm, P = .0168) directions. Furthermore, Group A had a statistically greater PDI, which was associated with development of DI (23.2 vs 16.6 mm, P = .0017).CONCLUSION:We were able to quantify pituitary descent and subsequent tension on the pituitary stalk, while also associating it with development of postoperative DI after pituitary adenoma resection.

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Section: Rationalementioning

confidence: 99%

Correlation of Pituitary Descent and Diabetes Insipidus After Transsphenoidal Pituitary Macroadenoma Resection

Gooderham

Akagami

et al. 2023

Neurosurgery

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“…DI results from the body's inability to create (central or cranial) or respond to (nephrogenic) arginine vasopressin (AVP) 1 . Patients can develop central DI through genetic, idiopathic, and neuropathic causes including primary brain tumours, head trauma, intracranial haemorrhage and infectious processes 2–4 . Preferred initial pharmacological treatment of central DI is desmopressin.…”

Section: What Is Known and Objectivementioning

confidence: 99%

“…1 Patients can develop central DI through genetic, idiopathic, and neuropathic causes including primary brain tumours, head trauma, intracranial haemorrhage and infectious processes. [2][3][4] Preferred initial pharmacological treatment of central DI is desmopressin.…”

Section: What Is Known and Objectivementioning

confidence: 99%

Delay in desmopressin therapy: Disaster in waiting

Kroll

Zandvakili

2022

Clinical Pharmacy Therapeu

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“…Se considera poliuria a una diuresis superior a 5cc/kg/hora y/o >80cc/m2/hora (>2L/m2/día) (3) en niños, siendo frecuente otras manifestaciones como deshidratación, falla para medrar, pérdida de peso, estreñimiento, fiebre (4) . La diabetes insípida central es una entidad poco frecuente con un incidencia en la población general de 3 en 100 000 con una ligera preponderancia masculina (60%) (5) .…”

Section: Introductionunclassified

Clinical profile of patients with Central Diabetes Insipidus at the Endocrinology Unit of Instituto Nacional de Salud del Niño (INSN) during 2001 -2010. Lima – Peru

De los Santos,

Del Aguila,

Rojas

et al. 2012

Rev Peru Pediatr

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Objetivo: Describir las características clínicas de los pacientes con diagnóstico de diabetes insípida central evaluados por el Servicio de Endocrinología del INSN durante un lapso de 10 años (enero 2001 a diciembre 2010). Materiales y métodos:Estudio descriptivo retrospectivo observacional. Se analizó retrospectivamente las historias clínicas de todos los pacientes con diagnóstico de diabetes insípida central entre 1 mes a 17 años 11 meses de edad diagnosticados entre el 1 de enero del 2001 al 31 de diciembre del 2010 por el Servicio de Endocrinología que cumplieron con los criterios de diabetes insípida central, pudiendo o no haberse realizado el test de restricción hídrica y que se encuentren dentro del lapso del estudio. No se incluyeron las historias clínicas que omitieron criterios importantes para el diagnóstico. Se evaluaron variables clínicas. El análisis estadístico incluyó aspectos descriptivos como determinación de promedios y rangos así como de frecuencias y porcentajes. Resultados: Se revisaron 149 historias clínicas con posible diagnóstico de diabetes insípida central y luego se seleccionaron 38 pacientes (65.8% fueron del sexo masculino). La edad promedio fue de 7.5± 3.68 años (0.08 – 16 años). Los pacientes en su mayoría fueron escolares entre 6 y 10 años de edad (39.5%). Con respecto a la etiología de la diabetes insípida central, se identificó una causa subyacente en el 84.2% de los pacientes siendo las causas adquiridas las más frecuentes (97.4%), destacando los tumores intracraneales (57.9%) en especial el craneofaringioma (42.1%). Los hallazgos clínicos más prevalentes los representaron la poliuria (100%), polidipsia (78.9%), cefalea (23.7%), nicturia (21.1%), talla baja (10.5%), vómitos (7.9%), fatiga (5.3%), pérdida de peso (2.6%). Se encontró alteraciones hormonales adenohipofisiarias en el 39.4% de los pacientes ocupando el primer lugar la deficiencia de tirotropina (36.8%) seguido por la deficiencia de hormona adrenocorticotrópica (34.2%). Conclusiones: La mayor frecuencia de diabetes insípida central en esta muestra fue en el sexo masculino y en el grupo de escolares. En la mayoría de pacientes con diabetes insípida central es posible identificar una causa subyacente. Las enfermedades adquiridas fueron las más representativas constituyendo los tumores intracraneales la principal etiología destacando entre ellos el craneofaringioma. Las alteraciones hormonales adenohipofisiarias pueden acompañar a la diabetes insípida central, de éstas las más frecuentes son la deficiencia de tirotropina (TSH) y de hormona adrenocorticotrópica (ACTH).

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Diabetes Insipidus

Cited by 11 publications

References 4 publications

Correlation of Pituitary Descent and Diabetes Insipidus After Transsphenoidal Pituitary Macroadenoma Resection

Correlation of Pituitary Descent and Diabetes Insipidus After Transsphenoidal Pituitary Macroadenoma Resection

Delay in desmopressin therapy: Disaster in waiting

Clinical profile of patients with Central Diabetes Insipidus at the Endocrinology Unit of Instituto Nacional de Salud del Niño (INSN) during 2001 -2010. Lima – Peru

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