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Central diabetes insipidus

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https://www.readbyqxmd.com/read/29675260/one-too-many-diabetes-the-combination-of-hyperglycaemic-hyperosmolar-state-and-central-diabetes-insipidus
#1
Snezana Burmazovic, Christoph Henzen, Lukas Brander, Luca Cioccari
The combination of hyperosmolar hyperglycaemic state and central diabetes insipidus is unusual and poses unique diagnostic and therapeutic challenges for clinicians. In a patient with diabetes mellitus presenting with polyuria and polydipsia, poor glycaemic control is usually the first aetiology that is considered, and achieving glycaemic control remains the first course of action. However, severe hypernatraemia, hyperglycaemia and discordance between urine-specific gravity and urine osmolality suggest concurrent symptomatic diabetes insipidus...
2018: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29659364/-association-between-central-diabetes-insipidus-and-type-2-diabetes-mellitus
#2
Claudia Palumbo, Nora Nicolaci, Andrés A La Manna, Natalia Branek, María N Pissano
Central diabetes insipidus is a rare disease of the hypothalamus and neurohypophysis. It is very unusually found in the adult with type 2 diabetes mellitus. It is manifested by a polydipsic polyuric syndrome, which must be distinguished from the poorly controlled type 2 diabetes mellitus. Given the similarity of both entities and the unusual nature of their coexistence, their suspicion is difficult. The case of a 72-year-old male with type 2 diabetes mellitus with poor insulin control (fasting hyperglycemia greater than 180 mg/dl) who had a long-standing polyuric syndrome is here presented...
2018: Medicina
https://www.readbyqxmd.com/read/29623580/management-and-consequences-of-postoperative-fluctuations-in-plasma-sodium-concentration-after-pediatric-brain-tumor-surgery-in-the-sellar-region-a-national-cohort-analysis
#3
R W J Kruis, A Y N Schouten-van Meeteren, M J J Finken, W Oostdijk, A S P van Trotsenburg, A M Boot, H L Claahsen-van der Grinten, E J van Lindert, K S Han, E W Hoving, E M C Michiels, H M van Santen
PURPOSE: Severe fluctuations in plasma sodium concentration and plasma osmolarity, including central diabetes insipidus (CDI), may have significant influence on postoperative morbidity and mortality after pediatric brain tumor surgery.The aim of this study was to describe the frequency, severity and neurological consequences of these fluctuations in pediatric brain tumor survivors. METHODS: A retrospective, multi-institutional chart review was conducted among all children who underwent brain tumor surgery in the sellar or suprasellar region in seven university hospitals in the Netherlands between January 2004 and December 2013...
April 5, 2018: Pituitary
https://www.readbyqxmd.com/read/29594922/intensification-of-induction-therapy-and-prolongation-of-maintenance-therapy-did-not-improve-the-outcome-of-pediatric-langerhans-cell-histiocytosis-with-single-system-multifocal-bone-lesions-results-of-the-japan-langerhans-cell-histiocytosis-study-group-02
#4
Akira Morimoto, Yoko Shioda, Toshihiko Imamura, Kazuko Kudo, Toshiyuki Kitoh, Hiroshi Kawaguchi, Hiroaki Goto, Yoshiyuki Kosaka, Yukiko Tsunematsu, Shinsaku Imashuku
Langerhans cell histiocytosis (LCH) with single-system (SS) multifocal bone (MFB) lesions is rarely fatal, but patients may experience relapses and develop LCH-associated sequelae. To evaluate effect on outcomes of pediatric multifocal LCH, we tested a treatment protocol modified from the Japan Langerhans Cell Histiocytosis Study Group (JLSG)-96 study. We assessed the outcomes of all consecutive newly diagnosed pediatric patients with LCH with SS-MFB lesions who were treated with JLSG-02 protocol in 2002-2009...
March 28, 2018: International Journal of Hematology
https://www.readbyqxmd.com/read/29594147/oxcarbazepine-therapy-for-complete-central-diabetes-insipidus
#5
Basmah Abdallah, Spencer Hodgins, Daniel Landry, Michael O'shea, Gregory Braden
Oxcarbazepine and carbamazepine cause hyponatremia by unknown mechanisms. We describe a patient with complete central diabetes insipidus and seizures who developed worsening hyponatremia when her dose of oxcarbazepine was increased. The patient maintained a normal serum sodium level and has had appropriately concentrated urine for 5 years on just oxcarbazepine, despite undetectable antidiuretic hormone (ADH) levels. This suggests that oxcarbazepine (or one of its metabolites) may stimulate collecting tubule V2 receptor-G protein complex independent of ADH, resulting in increased renal tubular water reabsorption...
January 2018: Case Reports in Nephrology and Dialysis
https://www.readbyqxmd.com/read/29535877/topical-imiquimod-for-the-treatment-of-relapsed-cutaneous-langerhans-cell-histiocytosis-after-chemotherapy-in-an-elderly-patient
#6
Shinsaku Imashuku, Miyako Kobayashi, Yoichi Nishii, Keisuke Nishimura
Diagnosis and treatment of Langerhans cell histiocytosis (LCH) in elderly patients are often difficult. We report here a 61-year-old female suffering from a refractory axillary ulcer for nearly a year, whose biopsy revealed LCH. It was also noted that the patient had other cutaneous papulovesicular eruptions of LCH as well as central diabetes insipidus. The patient was first successfully treated with multiagent chemotherapy (cytosine arabinoside/vinblastine/prednisolone). DDAVP also well controlled diabetes insipidus; however, the axillary ulcer and cutaneous LCH relapsed...
2018: Case Reports in Dermatological Medicine
https://www.readbyqxmd.com/read/29518865/-clinical-characteristics-of-central-diabetes-insipidus-a-retrospective-analysis-of-230-cases
#7
J P Zhang, Q H Guo, Y M Mu, Z H Lyu, W J Gu, G Q Yang, J Du, J M Ba, J M Lu
Objective: To evaluate the clinical characteristics and etiologies of central diabetes insipidus (CDI). Methods: The clinical data of 230 patients with CDI in the Department of Endocrinology of Chinese PLA General Hospital from 2008 June to 2014 December were collected and analyzed retrospectively. Results: The three most common causes of CDI were idiopathic CDI, lymphocytic hypophysitis and intracranial germ cell tumors. Among all the CDI, the idiopathic CDI accounted for 37.48%. There were significant differences in age onset and gender distribution among the different causes of CDI...
March 1, 2018: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29518762/diagnostic-value-of-the-water-deprivation-test-in-the-polyuria-polydipsia-syndrome
#8
Penelope Trimpou, Daniel S Olsson, Olof Ehn, Oskar Ragnarsson
OBJECTIVE: Diabetes insipidus (DI) and primary polydipsia (PP) are characterised by polyuria and polydipsia. It is crucial to differentiate between these two disorders since the treatment is different. The aim of this study was to evaluate the diagnostic value of the short and an extended variant of the water deprivation test (WDT) and of measuring urinary vasopressin (AVP) in patients with polyuria and polydipsia. DESIGN: A retrospective, single-centre study based on WDTs performed between 2004 and 2014 including 104 consecutive patients with the polyuria-polydipsia syndrome...
October 2017: Hormones: International Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29511565/combination-immune-checkpoint-inhibitor-therapy-nivolumab-and-ipilimumab-associated-with-multiple-endocrinopathies
#9
Florence Gunawan, Elizabeth George, Adam Roberts
Immune checkpoint inhibitors are the mainstay of treatment for advanced melanoma, and their use is being increasingly implicated in the development of autoimmune endocrinopathies. We present a case of a 52-year-old man with metastatic melanoma on combination nivolumab and ipilumimab therapy who developed concurrent hypophysitis, type 1 diabetes mellitus (T1DM) and diabetes insipidus. He presented prior to third cycle of combination treatment with a headache, myalgias and fatigue. Biochemistry and MRI pituitary confirmed anterior pituitary dysfunction with a TSH: 0...
2018: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29508304/hemorrhagic-fever-with-renal-syndrome-accompanied-by-panhypopituitarism-and-central-diabetes-insipidus-a-case-report
#10
Hee Jung Ahn, Jong-Hoon Chung, Dong-Min Kim, Na-Ra Yoon, Choon-Mee Kim
Central diabetes insipidus (DI) was detected in a patient with hemorrhagic fever with renal syndrome (HFRS) who had been molecularly and serologically diagnosed with Hantaan virus infection. We recommend that clinicians differentiate central DI in HFRS patients with a persistent diuretic phase even when pituitary MRI findings are normal.
March 5, 2018: Journal of Neurovirology
https://www.readbyqxmd.com/read/29497538/difficulties-in-cerebrospinal-fluid-%C3%AE-hcg-interpretation-in-a-patient-with-an-infundibular-lesion
#11
Alicia R Jones, Alan McNeil, Christopher Yates, Bala Krishnamurthy, Peter S Hamblin
A variety of neoplastic, inflammatory and congenital conditions can cause pituitary stalk thickening. Differentiating between these causes is important as targeted treatment may be offered. Diagnostic work-up consists of a thorough history, examination, biochemical analysis and imaging. We present the case of a 33-year-old male who presented with diabetes insipidus and had pituitary stalk thickening on magnetic resonance imaging. Further investigations revealed an elevated CSF βhCG, which raised the possibility of an intracranial germ cell tumor...
2018: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29497537/recurrent-pituitary-abscess-case-report-and-review-of-the-literature
#12
Raluca Maria Furnica, Julie Lelotte, Thierry Duprez, Dominique Maiter, Orsalia Alexopoulou
A 26-year-old woman presented with severe postpartum headaches. Magnetic resonance imaging (MRI) revealed a symmetric, heterogeneous enlargement of the pituitary gland. Three months later, she developed central diabetes insipidus. A diagnosis of postpartum hypophysitis was suspected and corticosteroids were prescribed. Six months later, the pituitary mass showed further enlargement and characteristics of a necrotic abscess with a peripheral shell and infiltration of the hypothalamus. Transsphenoidal surgery was performed, disclosing a pus-filled cavity which was drained...
2018: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29491282/manifestation-of-central-diabetes-insipidus-in-a-patient-with-thyroid-storm
#13
Akiko Nakamichi, Kazuki Ocho, Kosuke Oka, Miho Yasuda, Kou Hasegawa, Masaya Iwamuro, Mikako Obika, Kammei Rai, Fumio Otsuka
We herein report a case of central diabetes insipidus complicated with thyroid storm. A middle-aged woman who was receiving treatment for Graves' disease suddenly complained of polydipsia, polyuria and general fatigue. Laboratory tests showed hyperthyroidism, hypernatremia, hypoosmolar urine and a decreased plasma vasopressin level. The occurrence of central diabetes insipidus with hyperthyroidism was revealed on the basis of pituitary magnetic resonance imaging, a water deprivation test and a desmopressin test...
February 28, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29486290/functional-ectopic-neural-lobe-increases-gap-43-expression-via-pi3-k-akt-pathways-to-alleviate-central-diabetes-insipidus-after-pituitary-stalk-lesion-in-rats
#14
Zhanpeng Feng, Yichao Ou, Mingfeng Zhou, Guangsen Wu, Linzi Ma, Yuan Zhang, Yawei Liu, Songtao Qi
Central diabetes insipidus can occur after hypothalamic-hypophyseal tract injury. This injury is linked with a deficit in circulating vasopressin and oxytocin, which are produced in the supraoptic nuclei and the hypothalamic paraventricular nuclei. Previous studies indicate that an ectopic neural lobe forms after pituitary stalk lesion in rats, and while the relationship between an ectopic neural lobe and CDI outcomes is unclear, the underlying mechanisms are also unknown. Here, we report that two different CDI characteristics are shown in rats that underwent pituitary stalk electric lesion and are defined by two different groups classified as the recovery group and the no-recovery group...
February 24, 2018: Neuroscience Letters
https://www.readbyqxmd.com/read/29465100/central-diabetes-insipidus-unmasked-by-corticosteroid-therapy-for-cerebral-metastases-beware-the-case-with-pituitary-involvement-and-hypopituitarism
#15
H X Chin, T P Quek, M K Leow
Patients with intra-cerebral metastases often receive glucocorticoids, particularly in the presence of peri-lesional vasogenic cerebral oedema. We present a case of presumptive lung carcinoma with cerebral metastases where central diabetes insipidus was unmasked after glucocorticoid administration and correction of undiagnosed central hypocortisolism.
September 2017: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/29464737/copeptin-role-in-polyuria-polydipsia-syndrome-differential-diagnosis-and-reference-range-in-paediatric-age
#16
Gerdi Tuli, Daniele Tessaris, Silvia Einaudi, Patrizia Matarazzo, Luisa De Sanctis
OBJECTIVE: Plasma arginine-vasopressin (AVP) analysis can help in the differential diagnosis of the polyuria-polydipsia syndrome (PPS), even if such investigation is hampered by technical difficulties, conversely to its surrogate copeptin. This study aims to enlarge the existing data on normal copeptin levels in childhood, to evaluate the correlation between copeptin, serum sodium and plasma and urine osmolality, and to assess the utility of the copeptin analysis in the diagnostic work-up of PPS in the paediatric age...
February 21, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29463074/diabetes-insipidus-in-pregnancy-how-to-advice-the-patient
#17
Julie Refardt, Mirjam Christ-Crain
Diabetes insipidus, characterized by polyuria and polydipsia, is a rare disease during pregnancy. Nevertheless, its recognition is important to avoid complications due to dehydration and hypernatremia. Its manifestation during pregnancy ranges from exacerbation of pre-existing central or nephrogenic diabetes insipidus to transient pregnancy-induced diabetes insipidus due to the increased metabolism of the antidiuretic hormone vasopressin by the placental vasopressinase. Diagnosis can be challenging, as urinary frequency is common during pregnancy and primary polydipsia also needs to be excluded...
February 19, 2018: Minerva Endocrinologica
https://www.readbyqxmd.com/read/29440241/-if-there-were-water-we-should-stop-and-drink-neurofibromatosis-presenting-with-diabetes-insipidus
#18
Rachel Barry, Antoinette O' Connor, Mohn Hazriq Awang, Orna O' Toole
A 58-year-old right-handed woman presented to our institution with a 1-month history of polydipsia and polyuria. She had a remote history of neurofibroma excision by dermatology and, on examination, was noted to meet the clinical diagnostic criteria for neurofibromatosis type 1. Laboratory investigations revealed hypernatraemia and elevated serum osmolality, accompanied by reduced urinary osmolality. A subsequent water deprivation test confirmed central diabetes insipidus, which responded to treatment with desmopressin...
February 11, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29424204/relation-between-change-in-treatment-for-central-diabetes-insipidus-and-body-weight-loss
#19
Ayako Ito, Aya Nozaki, Ichiro Horie, Takao Ando, Atsushi Kawakami
BACKGOUND: Patients with central diabetes insipidus (CDI) are known to lose weight because their polydipsia interferes with their nutritional intake. We retrospectively examined weight changes in CDI patients when they switched from nasal to oral desmopressin. METHODS: Twenty-three patients with CDI were included. Weight change was defined as an increase or decrease of more than 3 kg or 3% body weight. As factors contributing to the weight change, we studied the patients' clinical characteristics and quality of life (QOL) scores as determined by our original questionnaire...
February 8, 2018: Minerva Endocrinologica
https://www.readbyqxmd.com/read/29422070/copeptin-levels-and-commonly-used-laboratory-parameters-in-hospitalised-patients-with-severe-hypernatraemia-the-co-med-study
#20
Nicole Nigro, Bettina Winzeler, Isabelle Suter-Widmer, Philipp Schuetz, Birsen Arici, Martina Bally, Julie Refardt, Matthias Betz, Gani Gashi, Sandrine A Urwyler, Lukas Burget, Claudine A Blum, Andreas Bock, Andreas Huber, Beat Müller, Mirjam Christ-Crain
BACKGROUND: Hypernatraemia is common in inpatients and is associated with substantial morbidity. Its differential diagnosis is challenging, and delayed treatment may have devastating consequences. The most important hormone for the regulation of water homeostasis is arginine vasopressin, and copeptin, the C-terminal portion of the precursor peptide of arginine vasopressin, might be a reliable new parameter with which to assess the underlying cause of hypernatraemia. METHODS: In this prospective, multicentre, observational study conducted in two tertiary referral centres in Switzerland, 92 patients with severe hyperosmolar hypernatraemia (Na+  > 155 mmol/L) were included...
February 9, 2018: Critical Care: the Official Journal of the Critical Care Forum
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