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

Neville, Kristen A; Pereira, John; Andrews, P.; Walker, Judith S.

doi:10.1515/jpem.2004.17.9.1245

Cited by 3 publications

(4 citation statements)

References 9 publications

(7 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The signal returned from the posterior pituitary gland by T1-weighted MRI is related to its functional integrity [1] and loss of the normal posterior pituitary bright spot (PPS) is described in primary diabetes insipidus [2,3] and in water intoxication [4]; however, this absence of PPS has not yet been reported in children with TBM but occurs frequently in our clinical experience and may be related to the serum sodium and SIADH levels in these patients.…”

Section: Introductionmentioning

confidence: 79%

“…The signal can change (loss of the bright spot) in conditions where there is no ADH production, such as primary diabetes insipidus [2,3]. A transient reduction in posterior pituitary bright signal has also been described in a child with water intoxication [4]. T1-signal hyperintensity may be due to high intracellular protein content (from hormone hypersecretion in the anterior pituitary lobe or from vasopressin storage in the posterior pituitary lobe) or artifacts (slow flow) [6].…”

Section: Mr Appearance Of the Pituitary Gland In Childrenmentioning

confidence: 99%

See 1 more Smart Citation

MR imaging of the posterior hypophysis in children with tuberculous meningitis

2009

View full text Add to dashboard Cite

The syndrome of inappropriate antidiuretic hormone secretion (SIADH) contributes to the morbidity and mortality in children with tuberculous meningitis (TBM). MRI assists in the early diagnosis of TBM and absence of the normal posterior pituitary bright spot (PPS) on T1-weighted MRI in TBM may indicate the functional integrity of the posterior hypophysis. The objective of this retrospective descriptive study of 22 children with TBM was to determine the prevalence of an absent PPS on T1-weighted MRI in children with TBM and its correlation with serum sodium levels (hyponatremia), severity of disease at presentation, and developmental outcome after 6 months. The prevalence of absent PPS in children with TBM was 55%. No significant correlation was found between the PPS and serum sodium status (p = 0.41) or severity of disease at presentation (p = 0.104). There was however a correlation between absent PPS and poorer developmental outcome at 6-month follow-up (p = 0.027).

show abstract

Section: Introductionmentioning

confidence: 79%

Section: Mr Appearance Of the Pituitary Gland In Childrenmentioning

confidence: 99%

MR imaging of the posterior hypophysis in children with tuberculous meningitis

2009

View full text Add to dashboard Cite

show abstract

“…Intraoperative initial fluid replacement should be performed with isotonic crystalloids. There is no evidence of superiority among different isotonic crystalloid solutions [22,[32][33][34][35].…”

Section: Intraoperatively [18]mentioning

confidence: 99%

Perioperative Fluid Therapy in the Pediatric Patient: Recommendations

Busto-Aguirreurreta¹,

Suarez²

2016

J Perioper Crit Intensive Care Nurs

View full text Add to dashboard Cite

“…An enlarged pituitary bright spot is seen in certain physiological conditions such as newborn, pregnancy or lactation but is usually anterior in position [9]. The loss of normal posterior pituitary bright spot (PPBS) was previously described in primary diabetes insipidus and in water intoxication [10,11]. Andronikou et al had found that there was absence of PPBS in 55% of children with TB meningitis [12].…”

Section: Introductionmentioning

confidence: 99%

Absence of posterior pituitary bright spot in adults with CNS tuberculosis: A case-control study

Smitesh

Mannam²,

Chandiraseharan³

et al. 2022

PLoS ONE

View full text Add to dashboard Cite

Introduction Current diagnostic methods used in Central Nervous System Tuberculosis (CNS TB) are limited by the paucibacillary nature of this form of tuberculosis. Posterior pituitary bright spot (PPBS) refers to an area of T1 hyperintensity in the posterior pituitary in MR imaging of the brain. It is found in 80–90% of healthy children and adults. In children with CNS TB, nearly half have absence of PPBS. This finding has not been described in adults. Our study looked for absence of PPBS in MR imaging and its association with CNS tuberculosis. Objective To study prevalence of the absence of PPBS in patients with CNS tuberculosis when compared to a control group of normal patients. Methods This was a retrospective case-control study of 100 patients with CNS tuberculosis and 200 controls (matched in 1:2 ratio) of patients with normal MRI brain. The MRI images were presented to a blinded radiologist in a randomised sequence to report for absence of PPBS. The data was subsequently analysed to look for association of absence of PPBS with CNS tuberculosis. Results Absence of PPBS (cases (47%), controls (8.5%)) was significantly associated with CNS tuberculosis in (Odds ratio-7.90, 95%CI 4.04–15.44, P-value<0.0001). The specificity, sensitivity, positive predictive value and positive likelihood ratio are 91.5%, 47%, 73.4% and 5.53 respectively. Adding of absence of PPBS as an additional radiological feature in diagnosis of CNS TB increased the sensitivity from 77% to 84%. Conclusion Absence of PPBS is significantly associated with CNS tuberculosis and could be a relatively simple diagnostic aid in the diagnosis of CNS tuberculosis.

show abstract

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

Cited by 3 publications

References 9 publications

MR imaging of the posterior hypophysis in children with tuberculous meningitis

MR imaging of the posterior hypophysis in children with tuberculous meningitis

Perioperative Fluid Therapy in the Pediatric Patient: Recommendations

Absence of posterior pituitary bright spot in adults with CNS tuberculosis: A case-control study

Contact Info

Product

Resources

About