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Atila C, Refardt J, Christ-Crain M. Arginine vasopressin deficiency: diagnosis, management and the relevance of oxytocin deficiency. Nat Rev Endocrinol 2024; 20:487-500. [PMID: 38693275 DOI: 10.1038/s41574-024-00985-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/26/2024] [Indexed: 05/03/2024]
Abstract
Polyuria-polydipsia syndrome can be caused by central diabetes insipidus, nephrogenic diabetes insipidus or primary polydipsia. To avoid confusion with diabetes mellitus, the name 'central diabetes insipidus' was changed in 2022 to arginine vasopressin (AVP) deficiency and 'nephrogenic diabetes insipidus' was renamed as AVP resistance. To differentiate the three entities, various osmotic and non-osmotic copeptin-based stimulation tests have been introduced in the past decade. The hypertonic saline test plus plasma copeptin measurement emerged as the test with highest diagnostic accuracy, replacing the water deprivation test as the gold standard in differential diagnosis of the polyuria-polydipsia syndrome. The mainstay of treatment for AVP deficiency is AVP replacement with desmopressin, a synthetic analogue of AVP specific for AVP receptor 2 (AVPR2), which usually leads to rapid improvements in polyuria and polydipsia. The main adverse effect of desmopressin is dilutional hyponatraemia, which can be reduced by regularly performing the so-called desmopressin escape method. Evidence from the past few years suggests an additional oxytocin deficiency in patients with AVP deficiency. This potential deficiency should be further evaluated in future studies, including feasible provocation tests for clinical practice and interventional trials with oxytocin substitution.
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Affiliation(s)
- Cihan Atila
- Department of Endocrinology, Diabetology and Metabolism, University Hospital Basel, Basel, Switzerland
- Department of Clinical Research University of Basel, University Hospital Basel, Basel, Switzerland
| | - Julie Refardt
- Department of Endocrinology, Diabetology and Metabolism, University Hospital Basel, Basel, Switzerland
- Department of Clinical Research University of Basel, University Hospital Basel, Basel, Switzerland
- Department of Internal Medicine, Section of Endocrinology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Mirjam Christ-Crain
- Department of Endocrinology, Diabetology and Metabolism, University Hospital Basel, Basel, Switzerland.
- Department of Clinical Research University of Basel, University Hospital Basel, Basel, Switzerland.
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Chasseloup F, Tabarin A, Chanson P. Diabetes insipidus: Vasopressin deficiency…. ANNALES D'ENDOCRINOLOGIE 2024; 85:294-299. [PMID: 38316255 DOI: 10.1016/j.ando.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 11/20/2023] [Indexed: 02/07/2024]
Abstract
Diabetes insipidus is a disorder characterized by hypo-osmotic polyuria secondary to abnormal synthesis, regulation, or renal action of antidiuretic hormone. Recently, an expert group, with the support of patient associations, proposed that diabetes insipidus be renamed to avoid confusion with diabetes mellitus. The most common form of diabetes insipidus is secondary to a dysfunction of the neurohypophysis (central diabetes insipidus) and would be therefore named 'vasopressin deficiency'. The rarer form, which is linked to renal vasopressin resistance (nephrogenic diabetes insipidus), would then be named 'vasopressin resistance'. The etiology of diabetes insipidus is sometimes clear, in the case of a neurohypophyseal cause (tumoral or infiltrative damage) or a renal origin, but in some cases diabetes insipidus can be difficult to distinguish from primary polydipsia, which is characterized by consumption of excessive quantities of water without any abnormality in regulation or action of antidiuretic hormone. Apart from patients' medical history, physical examination, and imaging of the hypothalamic-pituitary region, functional tests such as water deprivation or stimulation of copeptin by hyperosmolarity (induced by infusion of hypertonic saline) can be proposed in order to distinguish between these different etiologies. The treatment of diabetes insipidus depends on the underlying etiology, and in the case of a central etiology, is based on the administration of desmopressin which improves patient symptoms but does not always result in an optimal quality of life. The cause of this altered quality of life may be oxytocin deficiency, oxytocin being also secreted from the neurohypophysis, though this has not been fully established. The possibility of a new test using stimulation of oxytocin to identify alterations in oxytocin synthesis is of interest and would allow confirmation of a deficiency in those patients presenting with diabetes insipidus linked to neurohypophyseal dysfunction.
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Affiliation(s)
- Fanny Chasseloup
- Service d'endocrinologie et des maladies de la reproduction, centre de référence des maladies rares de l'hypophyse, université Paris-Saclay, Inserm, physiologie et physiopathologie endocriniennes, AP-HP, hôpital Bicêtre, Le Kremlin-Bicêtre, France.
| | - Antoine Tabarin
- Service d'endocrinologie, diabète et nutrition, hôpital Haut Lévêque, centre hospitalier universitaire de Bordeaux, Pessac, France
| | - Philippe Chanson
- Service d'endocrinologie et des maladies de la reproduction, centre de référence des maladies rares de l'hypophyse, université Paris-Saclay, Inserm, physiologie et physiopathologie endocriniennes, AP-HP, hôpital Bicêtre, Le Kremlin-Bicêtre, France
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Arima H, Cheetham T, Christ-Crain M, Cooper D, Drummond J, Gurnell M, Levy M, McCormack A, Newell-Price J, Verbalis JG, Wass J. Changing the Name of Diabetes Insipidus: A Position Statement of the Working Group for Renaming Diabetes Insipidus. J Clin Endocrinol Metab 2022; 108:1-3. [PMID: 36355385 PMCID: PMC9759163 DOI: 10.1210/clinem/dgac547] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Indexed: 11/12/2022]
Abstract
Recent data show that patients with a diagnosis of diabetes insipidus (DI) are coming to harm. Here we give the rationale for a name change to arginine vasopressin deficiency and resistance for central and nephrogenic DI, respectively.
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Affiliation(s)
- Hiroshi Arima
- Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan
| | - Timothy Cheetham
- Department of Pediatric Endocrinology, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
- Great North Children's Hospital (GNCH), Newcastle upon Tyne NE1 4LP, UK
| | - Mirjam Christ-Crain
- Correspondence: Mirjam Christ-Crain, MD, PhD, Division of Endocrinology and Diabetes, University hospital Basel, Petersgraben 4, CH-4031 Basel, Switzerland. ; or Joseph G. Verbalis, MD, Division of Endocrinology and Metabolism, Georgetown University Medical Center, Washington, DC 20007, USA.
| | | | - Juliana Drummond
- Department of Internal Medicine, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, MG CEP 31270-901, Brazil
| | - Mark Gurnell
- Wellcome-MRC Institute of Metabolic Science, University of Cambridge & Addenbrooke's Hospital, Cambridge CB2 0QQ, UK
| | - Miles Levy
- Department of Endocrinology, University Hospitals of Leicester NHS Trust, Leicester LE3 9QP, UK
| | - Ann McCormack
- Department of Endocrinology, St Vincent's Hospital, Sydney, NSW 2010, Australia
- Garvan Institute of Medical Research, Sydney, NSW 2010, Australia
- St Vincent's Clinical School, University of New South Wales, Sydney, NSW 2052, Australia
| | - John Newell-Price
- Department of Oncology and Metabolism, The Medical School, University of Sheffield, Sheffield S10 2RX, UK
| | - Joseph G Verbalis
- Correspondence: Mirjam Christ-Crain, MD, PhD, Division of Endocrinology and Diabetes, University hospital Basel, Petersgraben 4, CH-4031 Basel, Switzerland. ; or Joseph G. Verbalis, MD, Division of Endocrinology and Metabolism, Georgetown University Medical Center, Washington, DC 20007, USA.
| | - John Wass
- Department of Endocrinology, University of Oxford, Churchill Hospital, Oxford OX3 7LE, UK
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Arima H, Bichet DG, Cheetham T, Christ-Crain M, Drummond J, Gurnell M, Levy M, McCormack A, Newell-Price J, Verbalis JG, Wass J, Cooper D. Changing the name of diabetes insipidus. Pituitary 2022; 25:777-779. [PMID: 36334185 DOI: 10.1007/s11102-022-01276-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/24/2022] [Indexed: 11/07/2022]
Affiliation(s)
- Hiroshi Arima
- Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550, Japan
| | - Daniel G Bichet
- University of Montreal, Montreal, QC, H3T 1J4, Canada
- Hôpital du Sacré-Coeur de Montréal, Montreal, QC, H4J 1C5, Canada
| | - Timothy Cheetham
- Newcastle University, Newcastle Upon Tyne, NE1 7RU, UK
- Great North Children's Hospital (GNCH), Newcastle Upon Tyne, NE1 4LP, UK
| | - Mirjam Christ-Crain
- Department of Endocrinology, University Hospital and University of Basel, 4031, Basel, Switzerland
| | - Juliana Drummond
- Department of Internal Medicine, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, CEP 31270-901, Brazil
| | - Mark Gurnell
- Wellcome-MRC Institute of Metabolic Science, University of Cambridge & Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Miles Levy
- Department of Endocrinology, University Hospitals of Leicester NHS Trust, Leicester, LE3 9QP, UK
| | - Ann McCormack
- Department of Endocrinology, St Vincent's Hospital, Sydney, NSW, 2010, Australia
- Garvan Institute of Medical Research, Sydney, NSW, 2010, Australia
- St Vincent's Clinical School, University of New South Wales, Sydney, NSW, 2052, Australia
| | - John Newell-Price
- Department of Oncology and Metabolism, The Medical School, University of Sheffield, Beech Hill Road, Sheffield, S10 2RX, UK
| | - Joseph G Verbalis
- Georgetown-Howard Universities Center for Clinical and Translational Science, Georgetown University, Washington, DC, 20007, USA
| | - John Wass
- Department of Endocrinology, Churchill Hospital, University of Oxford, Oxford, OX3 7LE, UK.
| | - Deborah Cooper
- PricewaterhouseCoopers LLP, 7 More London Riverside, London, SE1 2RT, UK
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Arima H, Cheetham T, Christ-Crain M, Cooper D, Gurnell M, Drummond JB, Levy M, McCormack AI, Verbalis J, Newell-Price J, Wass JAH. Changing the name of diabetes insipidus: a position statement of The Working Group for Renaming Diabetes Insipidus. Endocr J 2022; 69:1281-1284. [PMID: 36244744 DOI: 10.1507/endocrj.ej20220831] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
"What's in a name? That which we call a rose/By any other name would smell as sweet." (Juliet, from Romeo and Juliet by William Shakespeare). Shakespeare's implication is that a name is nothing but a word and it therefore represents a convention with no intrinsic meaning. Whilst this may be relevant to romantic literature, disease names do have real meanings, and consequences, in medicine. Hence, there must be a very good rational for changing the name of a disease that has a centuries-old historical context. A working group of representatives from national and international endocrinology and pediatric endocrine societies now proposes changing the name of "diabetes insipidus" to "Arginine Vasopressin Deficiency (AVP-D)" for central etiologies, and "Arginine Vasopressin Resistance (AVP-R)" for nephrogenic etiologies. This editorial provides both the historical context and the rational for this proposed name change.
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Affiliation(s)
- Hiroshi Arima
- Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan
- Japan Endocrine Society
| | - Timothy Cheetham
- Paediatric Endocrinology, Newcastle University, Newcastle upon Tyne, NE1 7RU UK
- Paediatric Endocrinology, Great North Children's Hospital (GNCH), Newcastle upon Tyne, NE1 4LP, UK
- European Society for Pediatric Endocrinology
| | - Mirjam Christ-Crain
- Department of Endocrinology, University Hospital Basel, University of Basel, CH-4031 Basel, Switzerland
- European Society of Endocrinology
| | | | - Mark Gurnell
- European Society of Endocrinology
- Wellcome-MRC Institute of Metabolic Science, University of Cambridge & Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Juliana B Drummond
- Department of Internal Medicine, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, MG-CEP 31270-901, Brazil
- Brazilian Society of Endocrinology and Metabolism
| | - Miles Levy
- Department of Endocrinology, University Hospitals of Leicester NHS Trust, Leicester, LE3 9QP UK
- Society for Endocrinology
| | - Ann I McCormack
- Department of Endocrinology, St Vincent's Hospital, Sydney, NSW 2010, Australia
- Garvan Institute of Medical Research, Sydney, NSW 2010, Australia
- St Vincent's Clinical School, University of New South Wales, Sydney, NSW 2052, Australia
- Endocrine Society of Australia
| | - Joseph Verbalis
- Endocrinology and Metabolism, Georgetown-Howard Universities Center for Clinical and Translational Science, Georgetown University, Washington, DC 20007 USA
- Endocrine Society
| | - John Newell-Price
- Endocrine Society
- Department of Oncology and Metabolism, The Medical School University of Sheffield, SheffieldS10 2RX, UK
| | - John A H Wass
- Department of Endocrinology, Oxford Centre for Diabetes Endocrinology & Metabolism - Endocrinology, Oxford OX3 7LE, UK
- Pituitary Society
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Arima H, Cheetham T, Christ-Crain M, Cooper D, Gurnell M, Drummond JB, Levy M, McCormack AI, Verbalis J, Newell-Price J, Wass JAH. Changing the name of diabetes insipidus: a position statement of The Working Group for Renaming Diabetes Insipidus. Endocr Connect 2022; 11:e220378. [PMID: 36228658 PMCID: PMC9578068 DOI: 10.1530/ec-22-0378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 08/30/2022] [Indexed: 12/03/2022]
Abstract
'What's in a name? That which we call a rose/By any other name would smell as sweet' (Juliet, from Romeo and Juliet by William Shakespeare). Shakespeare's implication is that a name is nothing but a word, and it therefore represents a convention with no intrinsic meaning. While this may be relevant to romantic literature, disease names do have real meanings, and consequences, in medicine. Hence, there must be a very good rationale for changing the name of a disease that has a centuries-old historical context. A working group of representatives from national and international endocrinology, and pediatric endocrine societies now proposes changing the name of 'diabetes insipidus' to 'arginine vasopressin deficiency (AVP-D)' for central etiologies, and 'arginine vasopressin resistance (AVP-R)' for nephrogenic etiologies. This article provides both the historical context and the rationale for this proposed name change.
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Affiliation(s)
| | - Hiroshi Arima
- Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
- Japan Endocrine Society
| | - Timothy Cheetham
- Department of Paediatric Endocrinology, Newcastle University Faculty of Medical Sciences, Great North Children’s Hospital, Royal Victoria Infirmary, Newcastle upon Tyne, UK
- European Society for Pediatric Endocrinology
| | - Mirjam Christ-Crain
- Department of Endocrinology, Diabetes and Metabolism, University Hospital Basel, University of Basel, Switzerland
- European Society of Endocrinology
- Correspondence should be addressed to M Christ-Crain or J Verbalis: or
| | - Deborah Cooper
- Department of Endocrinology, Diabetes and Metabolism, University Hospital Basel, University of Basel, Switzerland
| | - Mark Gurnell
- European Society of Endocrinology
- Wellcome-MRC Institute of Metabolic Science, University of Cambridge & Addenbrooke’s Hospital, Cambridge Biomedical Campus, Cambridge, UK
| | - Juliana B Drummond
- Faculdade de Medicina da UFMG, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Brazilian Society of Endocrinology and Metabolism
| | - Miles Levy
- Endocrinology, University Hospitals of Leicester, Leicester, UK
- Society for Endocrinology
| | - Ann I McCormack
- Hormones and Cancer Group, Garvan Institute of Medical Research, Sydney, New South Wales, Australia
- Endocrine Society of Australia
| | - Joseph Verbalis
- Endocrinology and Metabolism, Georgetown University Medical Center, Washington DC, District of Columbia, USA
- Endocrine Society
- Correspondence should be addressed to M Christ-Crain or J Verbalis: or
| | - John Newell-Price
- Endocrine Society
- Department of Oncology and Metabolism, The Medical School, University of Sheffield, Sheffield, UK
| | - John A H Wass
- Department of Endocrinology, Oxford Centre for Diabetes Endocrinology & Metabolism – Endocrinology, Oxford, UK
- Pituitary Society
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Arima H, Cheetham T, Christ-Crain M, Cooper D, Gurnell M, Drummond JB, Levy M, McCormack AI, Verbalis J, Newell-Price J, Wass JAH. Changing the name of diabetes insipidus: a position statement of The Working Group for Renaming Diabetes Insipidus. Eur J Endocrinol 2022; 187:P1-P3. [PMID: 36239119 DOI: 10.1530/eje-22-0751] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 08/30/2022] [Indexed: 11/08/2022]
Abstract
'What's in a name? That which we call a rose/By any other name would smell as sweet.' (Juliet, from Romeo and Juliet by William Shakespeare). Shakespeare's implication is that a name is nothing but a word and it therefore represents a convention with no intrinsic meaning. Whilst this may be relevant to romantic literature, disease names do have real meanings, and consequences, in medicine. Hence, there must be a very good rationale for changing the name of a disease that has a centuries-old historical context. A working group of representatives from national and international endocrinology, nephrology and pediatric societies now proposes changing the name of 'diabetes insipidus' to 'arginine vasopressin deficiency (AVP-D)' for central etiologies and 'arginine vasopressin resistance (AVP-R)' for nephrogenic etiologies. This editorial provides both the historical context and the rationale for this proposed name change.
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Affiliation(s)
- Hiroshi Arima
- Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
- Japan Endocrine Society
| | - Timothy Cheetham
- Department of Paediatric Endocrinology, Newcastle University Faculty of Medical Sciences, Great North Children's Hospital, Royal Victoria Infirmary, Newcastle upon Tyne, UK
- European Society for Pediatric Endocrinology
| | - Mirjam Christ-Crain
- Department of Endocrinology, Diabetes and Metabolism, University Hospital Basel, University of Basel, Switzerland
- European Society of Endocrinology
| | | | - Mark Gurnell
- European Society of Endocrinology
- Wellcome-MRC Institute of Metabolic Science, University of Cambridge & Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, UK
| | - Juliana B Drummond
- Faculdade de Medicina da UFMG, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Brazilian Society of Endocrinology and Metabolism
| | - Miles Levy
- Endocrinology, University Hospitals of Leicester, Leicester, UK
- Society for Endocrinology
| | - Ann I McCormack
- Hormones and Cancer Group, Garvan Institute of Medical Research, Sydney, New South Wales, Australia
- Endocrine Society of Australia
| | - Joseph Verbalis
- Endocrinology and Metabolism, Georgetown University Medical Center, Washington DC, District of Columbia, USA
- Endocrine Society
| | - John Newell-Price
- Endocrine Society
- Department of Oncology and Metabolism, The Medical School, University of Sheffield, Sheffield, UK
| | - John A H Wass
- Department of Endocrinology, Oxford Centre for Diabetes Endocrinology & Metabolism - Endocrinology, Oxford, UK
- Pituitary Society
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Arima H, Cheetham T, Christ-Crain M, Cooper DL, Drummond JB, Gurnell M, Levy M, McCormack A, Newell-Price JD, Verbalis JG, Wass J. Changing the name of diabetes insipidus: a position statement of the working group to consider renaming diabetes insipidus. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2022; 66:868-870. [PMID: 36219203 PMCID: PMC10118767 DOI: 10.20945/2359-3997000000528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
"What's in a name? That which we call a rose / By any other name would smell as sweet" (Juliet, from Romeo and Juliet by William Shakespeare). Shakespeare's implication is that a name is nothing but a word and it therefore represents a convention with no intrinsic meaning. Whilst this may be relevant to romantic literature, disease names do have real meanings, and consequences, in medicine. Hence, there must be a very good rational for changing the name of a disease that has a centuries-old historical context. A working group of representatives from national and international endocrinology and endocrine pediatric societies now proposes changing the name of "diabetes insipidus" to "Arginine Vasopressin Deficiency (AVP-D)" for central etiologies, and "Arginine Vasopressin Resistance (AVP-R)" for nephrogenic etiologies This editorial provides both the historical context and the rational for this proposed name change.
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Arima H, Cheetham T, Christ-Crain M, Cooper D, Drummond J, Gurnell M, Levy M, McCormack A, Newell-Price J, Verbalis JG, Wass J. Changing the name of diabetes insipidus: a position statement of the working group to consider renaming diabetes insipidus. Clin Endocrinol (Oxf) 2022. [PMID: 36030512 DOI: 10.1111/cen.14819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 08/23/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Hiroshi Arima
- Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Japan
| | - Timothy Cheetham
- Newcastle University, Newcastle upon Tyne, UK
- Great North Children s Hospital (GNCH), Newcastle upon Tyne, UK
| | - Mirjam Christ-Crain
- Department of Endocrinology, University Hospital and University of Basel, Basel, Switzerland
| | | | - Juliana Drummond
- Department of Internal Medicine, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Mark Gurnell
- Wellcome-MRC Institute of Metabolic Science, University of Cambridge & Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, UK
| | - Miles Levy
- Department of Endocrinology, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Ann McCormack
- Department of Endocrinology, St Vincent's Hospital, Sydney, NSW, Australia
- Garvan Institute of Medical Research, Sydney, NSW, Australia
- St Vincent s Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - John Newell-Price
- Department of Oncology and Metabolism, The Medical School, University of Sheffield, Sheffield, UK
| | - Joseph G Verbalis
- Georgetown-Howard Universities Center for Clinical and Translational Science, Georgetown University, Washington, DC, USA
| | - John Wass
- Department of Endocrinology, University of Oxford, Churchill Hospital, Oxford, UK
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Prieto R, Rosdolsky M, Hofecker V, Barrios L, Pascual JM. Craniopharyngioma treatment: an updated summary of important clinicopathological concepts. Expert Rev Endocrinol Metab 2020; 15:261-282. [PMID: 32615875 DOI: 10.1080/17446651.2020.1770081] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 05/13/2020] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Craniopharyngiomas (CPs) are benign histological tumors that may develop at different positions along the hypothalamic-pituitary axis. Their close, heterogenous relationship to the hypothalamus makes surgical removal challenging even though this remains the primary treatment strategy. AREAS COVERED This article presents a critical overview of the pathological and clinical concepts regarding CPs that should be considered when planning treatment. Thus, we have performed a comprehensive review of detailed CP reports published between 1839 and 2020. EXPERT OPINION CP surgery should pursue maximal tumor resection while minimizing the risk of injuring the hypothalamus. Therefore, surgical strategies should be individualized for each patient. Accurate assessment of presenting symptoms and preoperative MRI has proven useful to predict the type of CP-hypothalamus relationship that will be found during surgery. CPs with dense and extensive adhesions to the hypothalamus should be highly suspected when MRI shows the hypothalamus positioned around the mid-third of the tumor and an amputated upper portion of the pituitary stalk. Symptoms related to functional impairment of the infundibulo-tuberal area of the third ventricle floor, such as obesity/hyperphagia, Fröhlich's syndrome, diabetes insipidus, and/or somnolence, also indicate risky CP-hypothalamic adhesions. In these cases, limited tumor removal is strongly advocated followed by radiation therapy.
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Affiliation(s)
- Ruth Prieto
- Department of Neurosurgery, Puerta de Hierro University Hospital , Madrid, Spain
| | | | - Verena Hofecker
- Pathologisch-anatomische Sammlung Im Narrenturm - NHM , Vienna, Austria
| | - Laura Barrios
- Statistics Department, Computing Center, CSIC , Madrid, Spain
| | - José M Pascual
- Department of Neurosurgery, La Princesa University Hospital , Madrid, Spain
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Castro-Dufourny I, Carrasco R, Prieto R, Pascual JM. Jean Camus and Gustave Roussy: pioneering French researchers on the endocrine functions of the hypothalamus. Pituitary 2017; 20:409-421. [PMID: 28265842 DOI: 10.1007/s11102-017-0800-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
At the beginning of the twentieth century, the hypothalamus was known merely as an anatomical region of the brain lying beneath the thalamus. An increasing number of clinicopathological reports had shown the association of diabetes insipidus and adiposogenital dystrophy (Babinski-Fröhlich's syndrome), with pituitary tumors involving the infundibulum and tuber cinereum, two structures of the basal hypothalamus. The French physicians Jean Camus (1872-1924) and Gustave Roussy (1874-1948) were the first authors to undertake systematic, controlled observations of the effects of localized injuries to the basal hypothalamus in dogs and cats by pricking the infundibulo-tuberal region (ITR) with a heated needle. Their series of surgical procedures, performed between 1913 and 1922, allowed them to claim that both permanent polyuria and adiposogenital dystrophy were symptoms caused by damage to the ITR. Their results challenged the dominant doctrine of hypopituitarism as cause of diabetes insipidus and adiposogenital dystrophy that derived from the experiments performed by Paulescu and Cushing a decade earlier. With their pioneering research, Camus and Roussy influenced the experimental work on the hypothalamus performed by Percival Bailey and Frederic Bremer at Cushing's laboratory, confirming the hypothalamic origin of these symptoms in 1921. More importantly, they provided the foundations for the physiological paradigm of Neuroendocrinology, the hypothalamus' control over the endocrine secretions of the pituitary gland, as well as over water balance and fat metabolism. This article aims to credit Camus and Roussy for their groundbreaking, decisive contributions to postulate the hypothalamus being the brain region in control of endocrine homeostasis and energy metabolism.
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Affiliation(s)
- Inés Castro-Dufourny
- Department of Endocrinology, Sureste University Hospital, C/ Ronda del Sur 10, Arganda del Rey, 28500, Madrid, Spain.
| | - Rodrigo Carrasco
- Department of Neurosurgery, Ramón y Cajal University Hospital, Madrid, Spain
| | - Ruth Prieto
- Department of Neurosurgery, Puerta de Hierro University Hospital, Madrid, Spain
| | - José M Pascual
- Department of Neurosurgery, La Princesa University Hospital, Madrid, Spain
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Bernal A, Mahía J, Puerto A. Animal models of Central Diabetes Insipidus: Human relevance of acquired beyond hereditary syndromes and the role of oxytocin. Neurosci Biobehav Rev 2016; 66:1-14. [DOI: 10.1016/j.neubiorev.2016.02.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 02/23/2016] [Accepted: 02/27/2016] [Indexed: 12/18/2022]
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Jain V, Ravindranath A. Diabetes insipidus in children. J Pediatr Endocrinol Metab 2016; 29:39-45. [PMID: 26353165 DOI: 10.1515/jpem-2014-0518] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 07/27/2015] [Indexed: 11/15/2022]
Abstract
Diabetes insipidus (DI) is one of the common disorders affecting sodium and water homeostasis, and results when ADH is either inadequately produced, or unable to negotiate its actions on the renal collecting tubules through aquaporins. The diagnostic algorithm starts with exclusion of other causes of polyuria and establishing low urine osmolality in the presence of high serum osmolality. In this paper, we have reviewed the diagnosis, etiology and management of DI in children, with special emphasis on recent advances in the field.
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Saifan C, Nasr R, Mehta S, Sharma Acharya P, Perrera I, Faddoul G, Nalluri N, Kesavan M, Azzi Y, El-Sayegh S. Diabetes insipidus: a challenging diagnosis with new drug therapies. ISRN NEPHROLOGY 2013; 2013:797620. [PMID: 24977135 PMCID: PMC4045430 DOI: 10.5402/2013/797620] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Accepted: 02/21/2013] [Indexed: 11/25/2022]
Abstract
Diabetes Insipidus (DI) is either due to deficient secretion of arginine vasopressin (central) or to tubular unresponsiveness (nephrogenic). Drug induced DI is a well-known entity with an extensive list of medications. Polyuria is generally defined as urine output exceeding 3 liters per day in adults. It is crucial to identify the cause of diabetes insipidus and to implement therapy as early as possible to prevent the electrolyte disturbances and the associated mortality and morbidity. It is very rare to have an idiosyncratic effect after a short use of a medication, and physicians should be aware of such a complication to avoid volume depletion. The diagnosis of diabetes insipidus is very challenging because it relies on laboratory values, urine output, and the physical examination of the patient. A high clinical suspicion of diabetes insipidus should be enough to initiate treatment. The complications related to DI are mostly related to the electrolyte imbalance that can affect the normal physiology of different organ systems.
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Affiliation(s)
- Chadi Saifan
- Division of Nephrology, Department of Medicine, Staten Island University Hospital, 475 Seaview Avenue, Staten Island, NY 10305, USA
| | - Rabih Nasr
- Division of Nephrology, Department of Medicine, Staten Island University Hospital, 475 Seaview Avenue, Staten Island, NY 10305, USA
| | - Suchita Mehta
- Division of Nephrology, Department of Medicine, Staten Island University Hospital, 475 Seaview Avenue, Staten Island, NY 10305, USA
| | - Pranab Sharma Acharya
- Division of Nephrology, Department of Medicine, Staten Island University Hospital, 475 Seaview Avenue, Staten Island, NY 10305, USA
| | - Isera Perrera
- Division of Nephrology, Department of Medicine, Staten Island University Hospital, 475 Seaview Avenue, Staten Island, NY 10305, USA
| | - Giovanni Faddoul
- Division of Nephrology, Department of Medicine, Staten Island University Hospital, 475 Seaview Avenue, Staten Island, NY 10305, USA
| | - Nikhil Nalluri
- Division of Nephrology, Department of Medicine, Staten Island University Hospital, 475 Seaview Avenue, Staten Island, NY 10305, USA
| | - Mayurakhan Kesavan
- Division of Nephrology, Department of Medicine, Staten Island University Hospital, 475 Seaview Avenue, Staten Island, NY 10305, USA
| | - Yorg Azzi
- Division of Nephrology, Department of Medicine, Staten Island University Hospital, 475 Seaview Avenue, Staten Island, NY 10305, USA
| | - Suzanne El-Sayegh
- Division of Nephrology, Department of Medicine, Staten Island University Hospital, 475 Seaview Avenue, Staten Island, NY 10305, USA
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15
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Pendleton C, Adams H, Mathioudakis N, Quiñones-Hinojosa A. Sellar door: Harvey Cushing's entry into the pituitary gland, the unabridged Johns Hopkins experience 1896-1912. World Neurosurg 2011; 79:394-403. [PMID: 22079823 DOI: 10.1016/j.wneu.2010.12.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2010] [Revised: 10/20/2010] [Accepted: 11/12/2010] [Indexed: 10/15/2022]
Abstract
OBJECTIVE To review the original surgical records from the Johns Hopkins Hospital, and analyze the records of patients Cushing treated for pituitary disorders from 1896 to 1912. METHODS Following IRB approval, and through the courtesy of the Alan Mason Chesney Archives, we reviewed the original surgical files from the Johns Hopkins Hospital. Patients presenting with pituitary-related symptoms, who underwent surgical treatment directed at the pituitary gland, were selected for further review. RESULTS Thirty-seven patients who underwent surgical intervention for pituitary disorders were found. Of these patients, 12 were mentioned only briefly in Cushing's 1912 monograph, whereas 6 were not described at all. The remaining 19 were documented by Cushing in his 1912 monograph. Cushing used three main surgical approaches to the pituitary: transsphenoidal, transcranial, and the subfrontal "omega incision." There were 6 inpatient deaths. The mean time to last follow-up was 41.0 months. At follow-up, headache was the most common unresolved symptom. CONCLUSION This review highlights Cushing's accomplishments in the surgical treatment of suspected pituitary pathology during his early career as a young attending at Johns Hopkins Hospital. It reveals new information about patients whom Cushing did not include in his publications detailing his surgical experience at the Johns Hopkins Hospital.
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Affiliation(s)
- Courtney Pendleton
- Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Eknoyan G. A History of Diabetes Insipidus: Paving the Road to Internal Water Balance. Am J Kidney Dis 2010; 56:1175-83. [DOI: 10.1053/j.ajkd.2010.08.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2010] [Accepted: 08/09/2010] [Indexed: 01/06/2023]
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Abstract
For centuries tumors have been described which today with some confidence can be diagnosed as craniopharyngiomas. It was not until 1904 Erdheim described what he called 'hypophysial duct tumors', and which Cushing later gave the name craniopharyngioma. The first operation for this neoplasm took place in 1909. It soon became evident that the outcome of surgery was rather dismal with high mortality and morbidity rates-even after corticosteroid therapy became available around 1950. Radiotherapy was introduced and later refined as radiosurgery. This paper presents a short survey of the accumulation of knowledge of craniopharyngiomas.
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Affiliation(s)
- J Lindholm
- Department of Endocrinology, Aarhus University Hospital, 9000, Aalborg, Denmark
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