Adipsic diabetes insipidus following pituitary surgery for a macroprolactinoma

Sherlock, Mark; Agha, Amar; Crowley, Rachel; Smith, Diarmuid; Thompson, Chris

doi:10.1007/s11102-006-8280-x

Cited by 25 publications

(8 citation statements)

References 26 publications

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“…Interestingly only two cases of pituitary tumors with ADI have been described (18, 32). Both these cases had an aggressive tumor with multiple trans-frontal resection and intracranial hemorrhage intra-operatively.…”

Section: Discussionmentioning

confidence: 99%

Adipsic Diabetes Insipidus—The Challenging Combination of Polyuria and Adipsia: A Case Report and Review of Literature

et al. 2019

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Adipsic Diabetes Insipidus is a rare hypothalamic disorder characterized by a loss of thirst in response to hypernatraemia accompanied by diabetes insipidus. These occur secondary to a congregation of defects in the homeostatic mechanisms of water balance. A 27-year old Chinese female presented with Adipsic Diabetes Insipidus after cerebral arteriovenous malformation (AVM) surgery. Initial diagnosis and management was extremely challenging. Long term management required a careful interplay between low dose vasopressin analog treatment and fluids. Detailed charts of medication and sodium balance are described in the case presentation. We performed a literature search of similarly reported cases and describe the possible pathogenesis, etiology, clinical presentation, acute and chronic management, and prognosis.

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Section: Discussionmentioning

confidence: 99%

Adipsic Diabetes Insipidus—The Challenging Combination of Polyuria and Adipsia: A Case Report and Review of Literature

et al. 2019

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“…[131519212630] When the excision of the tumor is planned after hormonal work up, many a times perioperatively electrolyte abnormalities are ignored. Though the complications and predictors related to water and electrolyte homeostasis following pituitary surgery in general and craniopharyngioma surgery in particular is well known, there is paucity of data regarding the choice of intraoperative fluid.…”

Section: Discussionmentioning

confidence: 99%

Choice of fluid therapy in patients of craniopharyngioma in the perioperative period: A hospital-based preliminary study

et al. 2014

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Background:Electrolyte imbalance and acute diabetes insipidus (DI) are the most common complications in patients undergoing craniopharyngioma surgery. Improper management of water and electrolyte imbalance is common cause of morbidity and mortality. Data is sparse and controversial regarding the choice of fluid therapy in this population during perioperative period.Methods:In this retrospective-prospective study involving 73 patients (58 retrospective), the type of fluid therapy was correlated with occurrence of hypernatremia, hyponatremia, DI, morbidity, and mortality. In the retrospective study, 48 patients received normal saline and 10 received mixed fluids as per the prevailing practice. In the prospective group, five patients each received normal saline, half normal saline, and 5% dextrose randomly.Results:The sodium values were significantly higher in first 48 h in the group that received normal saline compared with other groups (P < 0.001). The use of normal saline was associated with higher incidence of hypernatremia, DI, and mortality (P = 0.05), while the group that received 5% dextrose was associated with hyponatremia, hypoglycemia, and seizures. There was no perioperative hypotension with use of any of the fluids.Conclusion:Our results indicate half normal saline was fluid of choice with diminished incidence of water and electrolyte abnormalities without increase in mortality during postoperative period.

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“…[14][15][16][17] Similarly, reports in human medicine describe cases of hypodipsia with DI owing to structural brain diseases such as holoprosencephaly, cranial trauma, trauma secondary to intracranial surgery, pituitary ade noma, astrocytoma, hypothalamic hamartoma, crani opharyngioma and neurosarcoidosis. [18][19][20][21][22][23] This report describes the diagnosis and medical man agement of an adipsic cat diagnosed with DI secondary to a congenital pituitary cyst, which has never been described in the literature.…”

Section: Introductionmentioning

confidence: 92%

Congenital pituitary cyst resulting in adipsic central diabetes insipidus and secondary hypernatremia in a cat

Evenhuis

Epstein

Della-Maggiore

et al. 2021

Journal of Feline Medicine and Surgery Open Reports

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Case summary A 9-month-old intact female domestic mediumhair cat presented with a 5-month history of obtundation, lethargy, hypernatremia (181 mmol/l; reference interval [RI] 151–158 mmol/l), hyperchloremia (142 mmol/l; RI 117–126 mmol/l), azotemia (blood urea nitrogen 51 mg/dl; RI 18–33 mg/dl), creatinine 3.0 mg/dl (RI 1.1–2.2 mg/dl), hyperphosphatemia (8.3 mg/dl; RI 3.2–6.3 mg/dl) and total hypercalcemia (11.4 mg/dl; RI 9–10.9 mg/dl), with concurrent polyuria with adipsia. Neurologic evaluation revealed proprioceptive deficits, and this finding paired with a history of focal seizure-like activity despite improving sodium concentrations suggested a cerebrothalamic lesion. For this reason, and historical and biochemical findings consistent with adipsic diabetes insipidus (DI), MRI of the brain was performed, which revealed a lesion of the hypophyseal fossa consistent with a pituitary cyst. Given the patient’s age and the timeline of clinical signs, a congenital pituitary cyst was strongly suspected. The patient was managed initially with intravenous fluids to correct the hypernatremia, then managed for more than 4 years with topical ocular desmopressin acetate administration and free water administered through a feeding tube. This cat’s clinical diagnosis included a congenital pituitary cyst with subsequent central DI and primary adipsia. Relevance and novel information The clinical presentations of primary adipsia or central DI are both rare in cats. This is the first report to describe these conditions occurring in a cat owing to a congenital pituitary cyst and describes successful long-term management of this condition.

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Adipsic diabetes insipidus following pituitary surgery for a macroprolactinoma

Cited by 25 publications

References 26 publications

Adipsic Diabetes Insipidus—The Challenging Combination of Polyuria and Adipsia: A Case Report and Review of Literature

Adipsic Diabetes Insipidus—The Challenging Combination of Polyuria and Adipsia: A Case Report and Review of Literature

Choice of fluid therapy in patients of craniopharyngioma in the perioperative period: A hospital-based preliminary study

Congenital pituitary cyst resulting in adipsic central diabetes insipidus and secondary hypernatremia in a cat

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