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Front Vet Sci 2021 24;8:603262. Epub 2021 Mar 24.

Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Lithium (Li) is prescribed against a wide range of neurological disorders. Besides its excellent therapeutic properties, there are several adverse effects associated with Li. The impact of Li on renal function and diabetes insipidus is the most common adverse effect of this drug. Read More

Endocrine 2021 Apr 10. Epub 2021 Apr 10.

Department of Neurological Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.

Hypophysitis is a rare pituitary inflammatory disorder classified in different ways. Immunoglobulin G4-related disease (IgG4-RD), also a rare disease is a systemic fibro-inflammatory condition characterized by infiltration of tissue with IgG4-positive plasma cells; however prevalence of both of them probably is underestimated. In this paper, we present an Iranian patient with biopsy-proven IgG4-related hypophysitis and then review the clinical characteristics, laboratory, imaging, pathologic findings and therapeutic management as well as prognosis of 115 published cases of hypophysitis secondary to IgG4-related disease. Read More

BMJ Case Rep 2021 Apr 9;14(4). Epub 2021 Apr 9.

Department of Otolaryngology and Head and Neck Surgery, Guy's and Saint Thomas' NHS Foundation Trust, London, UK.

Cranial diabetes insipidus (DI), which can cause life-threatening dehydration, is treated with desmopressin, often intranasally. This is challenging in patients whose nasal airflow is altered, such as those requiring tracheostomy. We report the case of a patient, taking intranasal desmopressin for cranial DI, who underwent partial glossectomy, free-flap reconstruction and tracheostomy. Read More

Aging (Albany NY) 2021 Mar 26;13. Epub 2021 Mar 26.

Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

Hypothalamic nuclei in the preoptic and anterior hypothalamic region (POAH) are critically involved in thermoregulation and neuroendocrine regulation and can be displaced by craniopharyngiomas (CPs). We aimed to locate the POAH by visualizing hypothalamic thermoregulation through task-related functional magnetic resonance imaging (fMRI) to guide hypothalamus protection intraoperatively. Nine adult healthy volunteers (HVs) and thirty-two adult primary CP patients underwent task-related fMRI for POAH localization by warm (60° C) and cold (0° C) cutaneous thermoreceptor stimulation. Read More

Best Pract Res Clin Endocrinol Metab 2021 Feb 6:101489. Epub 2021 Feb 6.

USC Pituitary Center, Department of Neurosurgery, Keck School of Medicine of University of Southern California, 1300 N. State Street, Suite 3300, Los Angeles, CA, 90033, USA; Department of Medicine, Division of Endocrinology and Diabetes, Keck School of Medicine of University of Southern California, 1333 San Pablo Street, BMT-B11, Los Angeles, CA, 90033, USA. Electronic address:

Surgical failure or recurrence of Cushing's disease can be treated with medical therapy, radiotherapy, adrenalectomy, and/or repeat transsphenoidal surgery, all of which have their respective benefits and drawbacks. Redo transsphenoidal surgery has been shown to achieve at least short-term remission in about 40-80% of patients and is associated with low rates of morbidity and near-zero mortality, albeit higher rates of postoperative hypopituitarism, diabetes insipidus, and cerebrospinal fluid leak than initial resection. Despite this, recurrence may ensue in 50% of patients. Read More

Biomedicines 2021 Mar 15;9(3). Epub 2021 Mar 15.

Department of Biochemistry, School of Medicine, Tzu Chi University, Hualien 97004, Taiwan.

Congenital nephrogenic diabetes insipidus (CNDI) is a genetic disorder caused by mutations in arginine vasopressin receptor 2 () or aquaporin 2 genes, rendering collecting duct cells insensitive to the peptide hormone arginine vasopressin stimulation for water reabsorption. This study reports a first identified mutation in Taiwan and demonstrates our effort to understand the pathogenesis caused by applying computational structural analysis tools. The CNDI condition of an 8-month-old male patient was confirmed according to symptoms, family history, and DNA sequence analysis. Read More

J Appl Toxicol 2021 Apr 2. Epub 2021 Apr 2.

Department of Nephrology Transplantology and Internal Medicine, Poznań University of Medical Sciences, Poznań, Poland.

Despite the progress made in treating bipolar and unipolar affective disorders, lithium carbonate is still a common drug in psychiatric practice. Lithium-related renal side effects include nephrogenic diabetes insipidus, chronic tubulointerstitial nephropathy, and acute kidney injury (AKI). Nephrotic syndrome (NS) is an uncommon but severe complication of lithium treatment. Read More

Front Endocrinol (Lausanne) 2021 16;12:596654. Epub 2021 Mar 16.

Section of Paediatrics, Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, Verona, Italy.

In early 2020, a novel coronavirus leading to potentially death was discovered. Since then, the 2019 coronavirus disease (COVID-19) has spread to become a worldwide pandemic. Beyond the risks strictly related to the infection, concerns have been expressed for the endocrinological impact that COVID-19 may have, especially in vulnerable individuals with pre-existing endocrinological health conditions. Read More

Pediatrics 2021 Apr 1. Epub 2021 Apr 1.

Division of Pediatric Endocrinology and Metabolism, Mayo Clinic, Rochester, Minnesota

Arginine vasopressin (AVP)-mediated osmoregulatory disorders, such as diabetes insipidus (DI) and syndrome of inappropriate secretion of antidiuretic hormone (SIADH) are common in the differential diagnosis for children with hypo- and hypernatremia and require timely recognition and treatment. DI is caused by a failure to concentrate urine secondary to impaired production of or response to AVP, resulting in hypernatremia. Newer methods of diagnosing DI include measuring copeptin levels; copeptin is AVP's chaperone protein and serves as a surrogate biomarker of AVP secretion. Read More

Front Endocrinol (Lausanne) 2021 15;12:634415. Epub 2021 Mar 15.

Division of Endocrinology, Diabetes and Metabolism, University of Turin, Turin, Italy.

Traumatic brain injury (TBI)-related hypopituitarism has been recognized as a clinical entity for more than a century, with the first case being reported in 1918. However, during the 20 century hypopituitarism was considered only a rare sequela of TBI. Since 2000 several studies strongly suggest that TBI-mediated pituitary hormones deficiency may be more frequent than previously thought. Read More

Cureus 2021 Feb 23;13(2):e13523. Epub 2021 Feb 23.

Basic Sciences, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA.

Diabetes insipidus (DI) is an endocrine condition involving the posterior pituitary peptide hormone, antidiuretic hormone (ADH). ADH exerts its effects on the distal convoluted tubule and collecting duct of the nephron by upregulating aquaporin-2 channels (AQP2) on the cellular apical membrane surface. DI is marked by expelling excessive quantities of highly dilute urine, extreme thirst, and craving for cold water. Read More

J Neurol Surg B Skull Base 2021 Apr 24;82(2):175-181. Epub 2020 Jan 24.

Department of Neurological Surgery, Loyola University Stritch School of Medicine, Maywood, Illinois, United States.

 Higher surgical volumes correlate with superior patient outcomes for various surgical pathologies, including transnasal transsphenoidal (TNTS) pituitary tumor resection. With the introduction of endoscopic approaches, there have been nationwide shifts in technique with relative declines in microsurgery. We examined the volume-outcome relationship (VOR) for TNTS pituitary tumor surgery in an era of increasingly prevalent endoscopic approaches. Read More

Endocr J 2021 Mar 23. Epub 2021 Mar 23.

Komatsu University#, Komatsu 923-0921, Japan.

This Review Article overviews the literature on diabetes insipidus (DI) associated with pregnancy and labor in ‍Japan published from 1982 to 2019. The total number of patients collected was 361, however, only one-third of these cases ‍had detailed pathophysiologic information enabling us to identify the respective etiology and subtype. Pregnancy-associated DI can be divided into 3 etiologies, central (neurogenic) DI, nephrogenic DI, and excess vasopressinase-associated ‍DI. Read More

Zhonghua Er Ke Za Zhi 2021 Apr;59(4):322-326

Department of Nephrology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China.

To analyze the clinical features and efficacy of enzyme replacement therapy in 4 children with Fabry disease. A retrospective analysis of the clinical manifestations, laboratory findings, genetic variations and treatment were conducted in 4 children with Fabry disease in Children's Hospital of Zhejiang University School of Medicine from January 2014 to July 2020. All four children (2 males, 2 females) with onset age of 12. Read More

J Neuroendocrinol 2021 Mar;33(3):e12954

1st Department of Propaedeutic and Internal Medicine, National and Kapodistrian University of Athens, Athens, Greece.

Diabetes insipidus (DI) is a well-recognised transient or permanent complication following transsphenoidal surgery for pituitary adenomas or other sellar/parasellar lesions. However, data regarding the prevalence of pre-operative DI in sellar/parasellar lesions other than pituitary adenomas are scarce. We systematically reviewed the existing data for defining the prevalence of DI before any treatment in adult patients with sellar/parasellar lesions, excluding pituitary adenomas and metastatic lesions. Read More

Neurol Genet 2021 Apr 19;7(2):e578. Epub 2021 Mar 19.

Neuro-Immunology Unit (A.W-.Y., M.A.H.), Department of Neurology (O.S., A.F., F.B.), Department of Radiology (R.E.), and Neuro-Ophthalmology Unit, Department of Ophthalmology (H.S.K.), Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel; Sackler Faculty of Medicine (O.S., E.P., H.Y., L.B.-S., L.G., H.S.-K., F.B., Y.G.), Tel Aviv University, Tel Aviv, Israel; The Raphael Recanati Genetic Institute (A.F., Y.G., L.B.-S., L.B.), Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel; The Danek Gertner Institute of Human Genetics (E.P., H.Y., L.G.), Sheba Medical Center, Tel Hashomer, Israel; The Joseph Sagol Neuroscience Center (E.P., L.G.), Sheba Medical Center, Tel Hashomer, Israel; Department of Internal Medicine A (H.Y.), Sheba Medical Center, Tel Hashomer, Israel; Department of Genetics and Faculty of Medicine (S.S.-R.), Hadassah-Hebrew University Hospital, Jerusalem, Israel; Felsenstein Medical Research Center (O.S., L.B.-S., F.B.), Petach Tikva, Israel.

Objective: To describe the c.1672C>T; p.R558C missense variant, found in 1. Read More

Dev Med Child Neurol 2021 Mar 22. Epub 2021 Mar 22.

Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN, USA.

Aim: To examine the impact of clinical factors, cognitive deficits, and sleepiness on health-related quality of life (HRQoL) among young people with craniopharyngioma.

Method: Seventy-eight patients (67% White; 41 males, 37 females; mean age 10y 8mo, SD 3y 11mo, range 6-20y) with craniopharyngioma were assessed for tumor extent and diabetes insipidus. All patients underwent overnight polysomnography and multiple sleep latency tests after surgical resection. Read More

Am J Physiol Renal Physiol 2021 Mar 22. Epub 2021 Mar 22.

Department of Medicine and Physiology, Johns Hopkins University School of Medicine, United States.

The association between diabetes insipidus (DI) and chronic dietary potassium deprivation is well known but it remains uncertain how the disorder develops and whether it is influenced by the sexual dimorphism in potassium handling. Here, we determine the plasma potassium (P) threshold for DI in male and female mice and ascertain if the DI is initiated by polydipsia, or a central or nephrogenic defect. C57BL6J mice were randomized to a control diet or to graded reductions in dietary K for 8 days, and kidney function and transporters involved in water balance were characterized. Read More

World J Clin Cases 2021 Mar;9(8):1976-1982

Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.

Background: Germinoma is a type of germ cell tumor that most frequently arises in the midline axis of the brain. Impaired vision is a clinical manifestation of germinnoma. Although rare, intracranial germinoma seeding to the perioptic arachnoid space is one cause of visual acuity decrease. Read More

J Clin Med Res 2021 Feb 25;13(2):92-100. Epub 2021 Feb 25.

Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

Background: Desmopressin orally disintegrating tablet (ODT) was approved in March 2012 in Japan; the post-market safety reports, which warned about adequate initial dose of desmopressin ODT, were published in 2014. However, it is unclear how the warning affected physician and patient behavior.

Methods: We performed a retrospective single-center study to compare the clinical situation of Japanese central diabetes insipidus patients before and after the report. Read More

Neuroendocrinology 2021 Mar 19. Epub 2021 Mar 19.

Introduction: Role of glucocorticoids in primary autoimmune hypophysitis (PAH) has been fraught with variability in regimens leading to inconsistent outcomes in terms of anterior pituitary (AP) hormonal recovery. Hence, we aimed to compare the clinical, hormonal, and radiological outcomes of the standardized high-dose glucocorticoid therapy group (GTG) in PAH with a matched clinical observation group (COG).

Methods: 39 retrospective patients with PAH, evaluated and treated at a single center in Western India from 1999-2019 with a median follow-up duration of 48 months were subdivided into GTG (n=18) and COG (n=21) and compared for the outcomes Results: Baseline demographic, hormonal, and radiological features matched between the groups except pituitary height, which was significantly higher in GTG. Read More

JFMS Open Rep 2021 Jan-Jun;7(1):2055116921990294. Epub 2021 Feb 27.

Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California Davis, Davis, CA, USA.

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. Read More

Ann Acad Med Singap 2021 Feb;50(2):181-183

Department of General Medicine, Sengkang General Hospital, Singapore.

J Am Soc Nephrol 2021 Mar 16. Epub 2021 Mar 16.

Biogem, Institute of Genetic Research "Gaetano Salvatore", Ariano Irpino, Italy

Background: MicroRNAs (miRNAs), formed by cleavage of pre-microRNA by the endoribonuclease Dicer, are critical modulators of cell function by post-transcriptionally regulating gene expression.

Methods: Selective ablation of Dicer in AQP2-expressing cells (Dicer mice) was used to investigate the role of miRNAs in the kidney collecting duct of mice.

Results: The mice had severe polyuria and nephrogenic diabetes insipidus, potentially due to greatly reduced AQP2 and AQP4 levels. Read More

JCI Insight 2021 Mar 16. Epub 2021 Mar 16.

Department of Medicine, Emory University, Atlanta, United States of America.

Nephrogenic diabetes insipidus (NDI) patients produce large amounts of dilute urine. NDI can be congenital, resulting from mutations in the type-2 vasopressin receptor (V2R), or acquired, resulting from medications such as lithium. There are no good treatment options for NDI. Read More

BMJ Case Rep 2021 Mar 15;14(3). Epub 2021 Mar 15.

Hospital de Santa Maria, Serviço de Endocrinologia, Centro Hospitalar Lisboa Norte EPE, Lisboa, Portugal

Diabetes insipidus (DI) is characterised by thirst and polydipsia with hypotonic polyuria. Several forms exist, namely, central or pituitary, nephrogenic and gestational and must be differentiated for adequate treatment. We describe the case of a 41-year-old woman chronically infected with HIV who had been recently medicated with a tenofovir-based antiretroviral treatment and who, at 22 weeks of pregnancy, presented with transient gestational DI. Read More

Gulf J Oncolog 2021 Jan;1(35):86-91

Department of Endocrinology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.

Langerhans cell histiocytosis (LCH) is a rare clonal neoplastic disorder of Langerhans cells, with an incidence rate of 5 per million individuals. In adults LCH usually affects bone followed by lung, skin, pituitary gland, liver, spleen, and orbits. LCH presenting with endocrinopathy is rare and commonly involves posterior pituitary with central diabetes insipidus (DI). Read More

J Intern Med 2021 Mar 13. Epub 2021 Mar 13.

From the, Clinic for Endocrinology, Diabetes and Metabolism, University Hospital Basel, University of Basel, Basel, Switzerland.

Diabetes insipidus is a disorder characterized by excretion of large amounts of hypotonic urine. Four entities have to be differentiated: central diabetes insipidus resulting from a deficiency of the hormone arginine vasopressin (AVP) in the pituitary gland or the hypothalamus, nephrogenic diabetes insipidus resulting from resistance to AVP in the kidneys, gestational diabetes insipidus resulting from an increase in placental vasopressinase and finally primary polydipsia, which involves excessive intake of large amounts of water despite normal AVP secretion and action. Distinguishing between the different types of diabetes insipidus can be challenging. Read More

Asian J Neurosurg 2020 Oct-Dec;15(4):1020-1023. Epub 2020 Dec 21.

Department of Endocrinology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India.

Pituitary adenoma surgeries are common in neurosurgical setup. Majority are tackled by a transsphenoidal route either by endoscopic or microscopic aid. Complications such as cerebrospinal fluid (CSF) leak, meningitis, diabetes insipidus, hematoma, and loss of vision are known, but midbrain infarct is rarely reported. Read More