Hyperintense posterior pituitary lobe in central diabetes insipidus

1994 ◽  
Vol 36 (5) ◽  
pp. 380-381 ◽  
Author(s):  
A. Demirci ◽  
A. Okten ◽  
H. R. Gumele
Keyword(s):  
Diabetes Insipidus ◽  
Central Diabetes Insipidus ◽  
Posterior Pituitary ◽  
Posterior Pituitary Lobe

scholarly journals Idiopathic Central Diabetes Insipidus Is Associated with Abnormal Blood Supply to the Posterior Pituitary Gland Caused by Vascular Impairment of the Inferior Hypophyseal Artery System

2004 ◽  
Vol 89 (4) ◽  
pp. 1891-1896 ◽  
Author(s):  
Mohamad Maghnie ◽  
Monica Altobelli ◽  
Natascia di Iorgi ◽  
Eugenio Genovese ◽  
Giulia Meloni ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Pituitary Gland ◽  
Diabetes Insipidus ◽  
Blood Supply ◽  
Central Diabetes Insipidus ◽  
Posterior Pituitary ◽  
Central Nervous System Damage ◽  
Straight Sinus ◽  
Posterior Pituitary Gland ◽  
Posterior Pituitary Lobe

Abstract Central diabetes insipidus (CDI) has been linked to vascular central nervous system damage, although the pathophysiology of the mechanism has never been perfectly understood. Indeed, the vascular system of human pituitary gland has rarely been the subject of rigorous investigation except at postmortem. Recently, studies of pituitary gland blood supply have been carried out by means of a time evaluation of pituitary gland enhancement with noninvasive dynamic magnetic resonance (MR) imaging after contrast medium injection. In the present study, we decided to investigate the status of posterior pituitary blood supply by evaluating vascular pituitary patterns in a group of 19 patients with idiopathic CDI in whom previous standard MR imaging had failed to identify causal specific lesions. The control group was composed of 55 subjects with a median age of 12 yr (range, 4.2–17 yr) who had idiopathic isolated GH deficiency and normal pituitary morphology and 15 young adults (18–25 yr) who had normal pituitary gland and no endocrine dysfunction. Nineteen patients (12 females and seven males), ranging in age at the time of diagnosis of CDI from 0.5–14.9 yr (median, 5 yr), were examined with dynamic MR imaging between 1990 and 1997 at a median age of 14.1 yr (range, 5.0–26.3 yr). CDI was diagnosed according to clinical findings of polyuria and polydipsia, water deprivation test, and desmopressin acetate therapeutic trial. All of the patients had permanent CDI and were being treated with satisfactory results with desmopressin, two to three times daily, either intranasally or orally. The previous MR imaging findings of the 19 CDI patients had shown the absence of posterior pituitary hyperintensity, normal pituitary stalk, and normal anterior pituitary size. Enhancement of the straight sinus, representing a temporal reference point and occurring in normal subjects simultaneously to that of the posterior pituitary gland, was observed in all subjects after iv gadopentetate dimeglumine administration, with no substantial differences between patients and controls. However, the enhancement of the posterior pituitary lobe occurred simultaneously with the enhancement of the straight sinus in all of the controls but in only 14 of the 19 patients with CDI. In the remaining five patients, the enhancement of the straight sinus was not associated with the expected contrast enhancement of the posterior pituitary gland, suggesting abnormal blood supply to the posterior pituitary lobe. This is in keeping with vascular impairment of the inferior hypophyseal artery system and suggests that abnormal blood supply to the posterior pituitary gland is associated with what, until now, has been considered idiopathic CDI.

scholarly journals Pengelolaan Central Diabetes Insipidus Pasca Cedera Kepala Berat

2019 ◽  
Vol 8 (2) ◽  
pp. 99-104
Author(s):  
Bona Akhmad Fithrah ◽  
Marsudi Rasman ◽  
Siti Chasnak Saleh
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Diabetes Insipidus ◽  
Antidiuretic Hormone ◽  
Central Diabetes Insipidus ◽  
Young Generation ◽  
Posterior Pituitary ◽  
Challenging Problem ◽  
Mortality And Morbidity ◽  
Post Traumatic

Cedera otak traumatika adalah salah satu penyebab kematian dan kesakitan tersering pada kelompok masyarakat muda. Hasil akhir dari cedera kepala berat dapat menyebabkan gangguan kognitif, perilaku, psikologi dan sosial. Salah satu konsekuensi dari cedera kepala berat adalah terjadinya disfungsi hormonal baik dari hipofise anterior maupun posterior. Angka kejadian disfungsi hormonal ini sekitar 20-50%. Salah satu yang paling menantang dan sering terjadi adalah diabetes insipidus (DI) dan Syndrome inappropriate antidiuretic hormone (SIADH). Angka kejadian diabetes insipidus pasca cedera kepala diduga sebesar 1-2,9% dengan berbagai tingkatannya. Pada beberapa kasus bersifat sementara tapi beberapa kasus terjadi bersifat menetap. Pada laporan kasus ini akan dibawakan sebuah kasus diabetes insipidus pasca cedera kepala berat. Pasien mengalami cedera kepala berat, hingga dilakukan decompressive craniectomi dan trakeostomi. Untuk perawatan lanjutan pasien dirujuk ke Jakarta. Saat menjalani terapi lanjutan ini pasien terdiagnosis diabetes insipidus Pada kasus ini diabetes insipidus tidak timbul langsung setelah cedera kepala tetapi baru timbul lebih kurang satu bulan setelah cedera kepala. Diabetes insipidus dikelola dengan menggunakan desmopressin spray dan oral disamping mengganti cairan yang hilang. Pada kasus ini desmopressin sempat di stop sebelum akhirnya diberikan terus menerus dan pasien diterapi sebagai diabetes insipidus yang menetap. Managing Central Diabetes Insipidus in Post Severe Head Injury PatientAbstractTraumatic brain injury is the cause of mortality and morbidity in society mostly in male-young generation. The last outcome of traumatic brain injury might be deficit in cognitive, behavioral, psychological and social. the consequences of traumatic brain injury might be hormonal disfunction from anterior and posterior pituitary. The incidence around 20-50%. The most challenging problem is diabetes insipidus (DI) and syndrome of inappropriate antidiuretic hormone (SIADH). The incident of post traumatic diabetes insipidus around 1-2,9% with several degree. In certain case its only occurred transiently but some report it could be permanent. In this case report will find one case post traumatic diabetes insipidus. This pasien had severe traumatic brain injury and underwent decompressive craniectomy and tracheostomy. For further therapy patient was referred to Jakarta. In this further treatment patient diagnosed with diabetes insipidus. Diabetes insipidus doesn’t occurred since the first day of injury but occurred almost one month after. Diabetes insipidus managed with desmopressin spray and oral beside replace water loss. For a few days desmopressin stop but diabetes insipidus occurred again so desmopressin given daily both spray and oral and the patient had therapy as diabetes insipidus permanent. 

scholarly journals A Longitudinal Study of Vasopressin Cell Antibodies, Posterior Pituitary Function, and Magnetic Resonance Imaging Evaluations in Subclinical Autoimmune Central Diabetes Insipidus

1999 ◽  
Vol 84 (9) ◽  
pp. 3047-3051 ◽  
Author(s):  
A. De Bellis ◽  
A. Colao ◽  
F. Di Salle ◽  
V. I. Muccitelli ◽  
S. Iorio ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Autoimmune Diseases ◽  
Diabetes Insipidus ◽  
Central Diabetes Insipidus ◽  
Pituitary Function ◽  
Study Entry ◽  
Posterior Pituitary ◽  
Resonance Imaging

Cytoplasmic autoantibodies to vasopressin-cells (AVPcAb) have been detected not only in patients with overt central diabetes insipidus (CDI), but also in patients with endocrine autoimmune diseases without CDI. This suggests that complete CDI can be preceded by a preclinical stage. Among 878 patients with endocrine autoimmune diseases without CDI, 9 patients found to be AVPcAb positive and 139 AVPcAb-negative controls were enrolled in this open prospective study. They were evaluated for AVPcAb and posterior pituitary function at least yearly for about 4 yr (range, 37–48 months); during this span, magnetic resonance imaging (MRI) of posterior pituitary and stalk was performed only in the AVPcAb-positive patients. Five of the 9 AVPcAb-positive patients had normal posterior pituitary function at study entry. They were AVPcAb positive throughout the follow-up period. At later stages of the study, 3 of them developed partial CDI, and 1 developed complete CDI. The remaining 4 patients showed impaired response to the water deprivation test at study entry and were diagnosed as having partial CDI. Two of them agreed to receive desmopressin replacement for 1 yr. After this treatment, the patients became negative for AVPcAb and displayed normal posterior pituitary function until the end of the follow-up. Conversely, the 2 untreated patients with partial CDI remained AVPcAb positive. One of them developed overt CDI. None of the controls became AVPcAb positive or developed CDI. The normal hyperintense MRI signal of the posterior pituitary, present at study entry, persisted subsequently in all 9 AVPcAb-positive patients, including those developing overt CDI, only disappearing in the late phase of complete CDI. In asymptomatic subjects, the monitoring of AVPcAb, but not MRI, seems to be useful to predict a progression toward partial/overt CDI. Early desmopressin therapy in patients with partial CDI could interrupt or delay the autoimmune damage and the progression toward clinically overt CDI.

scholarly journals Transient Central Diabetes Insipidus after Discontinuation of Vasopressin

2019 ◽  
Vol 2019 ◽  
pp. 1-4 ◽  
Author(s):  
Nathaniel Carman ◽  
Carl Kay ◽  
Abigail Petersen ◽  
Maria Kravchenko ◽  
Joshua Tate
Keyword(s):  
Risk Factors ◽  
Septic Shock ◽  
Diabetes Insipidus ◽  
Neurological Disease ◽  
Sodium Concentration ◽  
Central Diabetes Insipidus ◽  
Posterior Pituitary ◽  
Vasopressin Secretion ◽  
Posterior Pituitary Gland ◽  
Uncommon Condition

Central diabetes insipidus (CDI) is an uncommon condition resulting from lack of vasopressin secretion from the posterior pituitary gland typically caused by some form of destruction of the gland. Here we present a case of transient CDI after discontinuation of vasopressin used for septic shock without evidence of overt pituitary damage. Serum sodium concentration peaked at 160 mmol/L in the setting of polyuria within days of vasopressin discontinuation without identified alternative etiologies. Sodium levels and urine output normalized with administration of desmopressin with continued stability after desmopressin was discontinued. This is one of few reported cases of diabetes insipidus occurring after discontinuation of vasopressin and the rapid and profound response to desmopressin in this case proves a central etiology. This case allows for speculation into predisposing risk factors for this phenomenon including preexisting neurological disease.

scholarly journals Causes and Follow-Up of Central Diabetes Insipidus in Children

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Wendong Liu ◽  
Jing Hou ◽  
Xiuqin Liu ◽  
Limin Wang ◽  
Guimei Li
Keyword(s):  
Diabetes Insipidus ◽  
Signal Intensity ◽  
Central Diabetes Insipidus ◽  
Pituitary Stalk ◽  
Control Group ◽  
Pituitary Hormone ◽  
Posterior Lobe ◽  
Healthy Children ◽  
Posterior Pituitary ◽  
Urine Testing

Objective. To identify the causes of central diabetes insipidus (CDI) by evaluating the values of magnetic resonance imaging (MRI) in the diagnosis of pediatric CDI, providing evidence for the clinical diagnosis and treatment of CDI. Methods. Seventy-nine patients with CDI (CDI group) hospitalized from July 2012 to March 2017 and 43 healthy children (control group) were enrolled in this study. All cases underwent MRI examination including T1-weighted three-dimensional magnetization-prepared rapid gradient-echo (T1WI-3D-MP RAGE) imaging sequences. The pituitary volume, the signal intensity of posterior pituitary, and the morphology of pituitary stalk were measured between two groups. The medical history, urine testing, imaging of hypothalamic-pituitary region, and hormone levels were also recorded. Results. Age and gender were matched between the CDI and control groups. The height and BMI in the CDI group were less and the urine volume in 24 h was higher than those in the control group. The signal intensity of the posterior pituitary was higher in the control group, whereas the pituitary volume was smaller in the CDI group. In the CDI group, 44 cases presented with morphological changes of the pituitary stalk. Clinical symptoms mainly included polydipsia, polyuria, short stature, and vomiting. All patients were confirmed by water deprivation vasopressin test. Forty-four CDI children were associated with hypopituitarism, including 33 cases of PSIS with multiple pituitary hormone deficiencies (MPHD) and 11 cases of growth hormone deficiency (IGHD). The pituitary volume in the cases of pituitary stalk interruption syndrome (PSIS) with MPHD was smaller than that in the IGHD patients. Conclusions. The signal intensity ratio of the posterior lobe, pituitary volume, and the morphology of pituitary stalk on T1WI-3D-MP RAGE image contribute to the diagnosis of CDI.

scholarly journals Central diabetes insipidus induced by temozolomide: A literature Review

2021 ◽  
Author(s):  
Mohammad D. Hossain ◽  
Abu Bakar Siddik ◽  
Susmita Dey Pinky ◽  
Tonazzina Hossain Sauda ◽  
Fahtiha Nasreen ◽  
...  
Keyword(s):  
Diabetes Insipidus ◽  
English Language ◽  
Therapeutic Response ◽  
Clinical Course ◽  
Hormone Secretion ◽  
Central Diabetes Insipidus ◽  
Severe Adverse Effect ◽  
Posterior Pituitary ◽  
Chemotherapeutic Drug ◽  
Cns Malignancies

AbstractTemozolomide has been the most used chemotherapeutic drug for glioblastoma and various CNS malignancies. Although myelosuppression has the most severe adverse effect, central diabetes insipidus (CDI) has been found as an infrequent side effect. CDI is characterized by decreased antidiuretic hormone secretion from posterior pituitary, thereby the inability to concentrate the urine with variable degrees of polyuria and compensatory polydipsia. Following a comprehensive literature search of several databases from 1990 to October 2020, which were limited to the English language, patient data were analyzed to demonstrate the risk factors, severity, reversibility of the disease, and overall survival. Total nine cases found who developed CDI following TMZ treatment. All patients manifest hyperosmolar symptoms like polyuria and polydipsia within 3 to 12 weeks following temozolomide initiation. Clinical and laboratory features, therapeutic response to exogenous desmopressin, and clinical course have been summarized.

scholarly journals Sheehan's syndrome with central diabetes insipidus

2011 ◽  
Vol 55 (2) ◽  
pp. 171-174 ◽  
Author(s):  
Bashir Ahmad Laway ◽  
Shahnaz Ahmad Mir ◽  
Mohd Iqbal Dar ◽  
Abdul Hamid Zargar
Keyword(s):  
Diabetes Insipidus ◽  
Postpartum Hemorrhage ◽  
Clinical Course ◽  
Empty Sella ◽  
Central Diabetes Insipidus ◽  
Posterior Pituitary ◽  
Test Results ◽  
Sheehan’S Syndrome ◽  
Pituitary Dysfunction ◽  
Sheehan's Syndrome

Sheehan's syndrome refers to the occurrence of hypopituitarism after delivery, usually preceded by postpartum hemorrhage. The condition still continues to be a common cause of hypopituitarism in developing countries like India. The disorder usually presents with anterior pituitary failure with preservation of posterior pituitary functions. Posterior pituitary dysfunction in the form of central diabetes insipidus is rare in patients with Sheehan's syndrome. We describe the clinical course of a young lady who after her sixth childbirth developed severe postpartum hemorrhage followed by development of panhypopituitarism which was confirmed by hormonal investigation and demonstration of empty sella on imaging. In addition, she developed Polyuria. The water deprivation test and response to vasopressin test results indicated central diabetes insipidus. She needed oral desmopressin on a continuous basis to control polyuria.

Sign in / Sign up

Export Citation Format

Share Document