Disordered Control of Thirst in Hypothalamic-Pituitary Sarcoidosis

Stuart, Charles Alexander; Neelon, Francis A.

doi:10.1056/nejm198011063031902

Cited by 107 publications

(39 citation statements)

References 39 publications

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“…Polydipsia has been observed in up to 20% of psychiatric inpatients, with incidences of intermittent hyponatremia ranging from 5% to 10%. 41 Despite the frequent occurrence of polydipsia in psychiatric patients, it is important to recognize that not all polydipsia is caused by psychiatric disease; infiltrative diseases such as central nervous system (CNS) sarcoidosis 42 or critically located brain tumors can also be associated with increased thirst and fluid ingestion. Consequently, patients with polydipsia should be evaluated with a computed tomography or magnetic resonance imaging (MRI) scan of the brain before concluding that excessive water intake is due to a psychiatric cause.…”

Section: Eahmentioning

confidence: 99%

Hyponatremia Treatment Guidelines 2007: Expert Panel Recommendations

Verbalis

Goldsmith

Greenberg

et al. 2007

The American Journal of Medicine

521

498

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Although hyponatremia is a common, usually mild, and relatively asymptomatic disorder of electrolytes, acute severe hyponatremia can cause substantial morbidity and mortality, particularly in patients with concomitant disease. In addition, overly rapid correction of chronic hyponatremia can cause severe neurologic deficits and death, and optimal treatment strategies for such cases are not established. Hyponatremia is the most common disorder of electrolytes encountered in clinical practice, occurring in up to 15% to 30% of both acutely and chronically hospitalized patients. 1 Although most cases are mild and relatively asymptomatic, hyponatremia is important clinically because: (1) acute severe hyponatremia can cause substantial morbidity and mortality; (2) mortality is higher in patients with hyponatremia who have a wide range of underlying diseases; and (3) overly rapid correction of chronic hyponatremia can cause severe neurologic deficits and death.Despite knowledge of hyponatremia since the mid-20th century, this common disorder remains incompletely understood in many basic areas because of its association with a plethora of underlying disease states, and its multiple etiologies with differing pathophysiologic mechanisms. 2 Optimal treatment strategies have not been well defined, both for these reasons and because of marked differences in symptomatology and clinical outcomes based on the acuteness or chronicity of the hyponatremia. 3 Vasopressin receptor antagonists have long been anticipated as a more effective method to treat hyponatremia by virtue of their unique aquaretic effect to selectively increase solute-free water excretion by the kidneys. 4 The recent approval of the first such agent, conivaptan, for clinical use by the US Food and Drug Administration (FDA) heralds the beginning of a new era in the management of hyponatremic disorders. However, effective therapy with these agents will require intelligent guidelines for their use. To this end, a panel of experts in hyponatremia convened to review current therapies for hyponatremia and to evaluate the situations in which aquaretic agents should be considered as alternatives or supplements to accepted current therapies. This review is a summary of the conclusions of this panel.

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Section: Eahmentioning

confidence: 99%

Hyponatremia Treatment Guidelines 2007: Expert Panel Recommendations

Verbalis

Goldsmith

Greenberg

et al. 2007

The American Journal of Medicine

521

498

View full text Add to dashboard Cite

show abstract

“…3. ported to be around 1%(2, 3), and usually causes diabetes insipidus (4,5) and various degrees of impaired secretion of anterior pituitary hormones (2,3,(5)(6)(7)(8)(9). Involvement of the adrenal gland is sarcoidosis is also rare and sometimescauses primary adrenal insufficiency (4, 10, 1 1).…”

Section: Case Reportmentioning

confidence: 99%

Cushing's Disease Preceding Sarcoidosis.

et al. 1995

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“…Diabetes insipidus is considered the most common manifestation, accounting for half of all neuroendocrine abnormalities (Chapelon et al 1990). Of note, an organic primary polydipsia may also be the cause of polyuria and polydipsia, and hypercalcemia from sarcoidosis can cause nephrogenic diabetes insipidus (Stuart et al 1980). Other relatively common neuroendocrine manifestations of sarcoidosis include amenorrhea or galactorrhea.…”

Section: Clinical Manifestationsmentioning

confidence: 99%