SOCIETY FOR ENDOCRINOLOGY CLINICAL GUIDANCE: Inpatient management of cranial diabetes insipidus

Baldeweg, Stephanie E; Ball, Stephen G.; Brooke, Antonia; Gleeson, Helena; Levy, Miles; Prentice, Malcolm; Wass, John

doi:10.1530/ec-18-0154

Cited by 44 publications

(40 citation statements)

References 3 publications

(3 reference statements)

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“…DI represents a life-threatening entity when the thirst mechanism is impaired, as in cases of hypothalamic disorder or reduced consciousness or lack of water availability such as in cases of physical disability resulting in severe dehydration and death. For this reason, a Society for Endocrinology guideline has been recently issued for the in-patient management of patients with CDI [7,86].…”

Section: Central Diabetes Insipidus (Cdi)mentioning

confidence: 99%

Management of Hypopituitarism

Alexandraki

Grossman

2019

JCM

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Hypopituitarism includes all clinical conditions that result in partial or complete failure of the anterior and posterior lobe of the pituitary gland’s ability to secrete hormones. The aim of management is usually to replace the target-hormone of hypothalamo-pituitary-endocrine gland axis with the exceptions of secondary hypogonadism when fertility is required, and growth hormone deficiency (GHD), and to safely minimise both symptoms and clinical signs. Adrenocorticotropic hormone deficiency replacement is best performed with the immediate-release oral glucocorticoid hydrocortisone (HC) in 2–3 divided doses. However, novel once-daily modified-release HC targets a more physiological exposure of glucocorticoids. GHD is treated currently with daily subcutaneous GH, but current research is focusing on the development of once-weekly administration of recombinant GH. Hypogonadism is targeted with testosterone replacement in men and on estrogen replacement therapy in women; when fertility is wanted, replacement targets secondary or tertiary levels of hormonal settings. Thyroid-stimulating hormone replacement therapy follows the rules of primary thyroid gland failure with L-thyroxine replacement. Central diabetes insipidus is nowadays replaced by desmopressin. Certain clinical scenarios may have to be promptly managed to avoid short-term or long-term sequelae such as pregnancy in patients with hypopituitarism, pituitary apoplexy, adrenal crisis, and pituitary metastases.

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Section: Central Diabetes Insipidus (Cdi)mentioning

confidence: 99%

Management of Hypopituitarism

Alexandraki

Grossman

2019

JCM

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“…-In 2018, the Society for Endocrinology (SfE) published guidelines on in-hospital management of central DI 15 . This report was prompted by a study of patients hospitalized with central DI, which showed that desmopressin treatment had been missed or delayed in 88% of admissions, and that 35% of patients consequently developed dysnatraemia 16 .…”

Section: Acute Infection With Suspected or Confirmed Covid-19mentioning

confidence: 99%

ENDOCRINOLOGY IN THE TIME OF COVID-19: Management of diabetes insipidus and hyponatraemia

Christ‐Crain

Hoorn

Sherlock

et al. 2020

European Journal of Endocrinology

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Running title: DI and hypontraemia in times of COVID-19Word count abstract: 210 words Word count: 2'500 Number of tables: 2This manuscript is part of a commissioned series of urgent clinical guidance documents on the management of endocrine conditions in the time of COVID-19. This clinical guidance document underwent expedited open peer review by Joe Verbalis (USA), Jens Otto Jørgensen (Denmark), Stefan Bilz (Switzerland) and Georg Lindner (Switzerland).Disclaimer: Due to the emerging nature of the COVID-19 crisis this document is not based on extensive systematic review or meta-analysis, but on rapid expert consensus. The document should be considered as guidance only; it is not intended to determine an absolute standard of medical care. Healthcare staff need to consider individual circumstances when devising the management plan for a specific patient. AbstractCOVID-19 has changed the nature of medical consultations, emphasizing virtual patient counseling, with relevance for patients with diabetes insipidus (DI) or hyponatremia.The main complication of desmopressin treatment in DI is dilutional hyponatraemia. Since plasma sodium monitoring is not always possible in times of COVID-19, we recommend to

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“…Further guidance for emergency management of diabetes insipidus is available from the Society for Endocrinology website. 29…”

Section: Management Of Adrenal Crisis In Adultsmentioning

confidence: 99%

Guidance for the prevention and emergency management of adult patients with adrenal insufficiency

et al. 2020

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Adrenal insufficiency (AI) is an often-unrecognised endocrine disorder, which can lead to adrenal crisis and death if not identified and treated. Omission of steroids in patients with AI, particularly during physiological stress such as an intercurrent illness or surgery, can also lead to an adrenal crisis. The National Reporting and Learning System (NRLS) identified 78 incidents including two deaths and six incidents of severe harm to patients in a recent 4-year period. This guidance will go through causes of adrenal insufficiency, groups at risk of an adrenal crisis, emergency management and management for surgical procedures. A new NHS Steroid Emergency Card has been developed to be carried by patients at risk of adrenal crisis. We hope the new emergency card and this guidance will increase awareness of the need to start steroids promptly in patients at risk of an adrenal crisis, particularly those presenting in the emergency department or to acute medicine teams and those undergoing surgery or invasive procedures.

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SOCIETY FOR ENDOCRINOLOGY CLINICAL GUIDANCE: Inpatient management of cranial diabetes insipidus

Cited by 44 publications

References 3 publications

Management of Hypopituitarism

Management of Hypopituitarism

ENDOCRINOLOGY IN THE TIME OF COVID-19: Management of diabetes insipidus and hyponatraemia

Guidance for the prevention and emergency management of adult patients with adrenal insufficiency

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