pituitrin and Glioblastoma

Central diabetes insipidus is a heterogeneous condition characterized by decreased release of antidiuretic hormone by the neurohypophysis resulting in a urine concentration deficit with variable degrees of polyuria. The most common causes include idiopathic diabetes insipidus, tumors or infiltrative diseases, neurosurgery and trauma. Temozolomide is an oral DNA-alkylating agent capable of crossing the blood-brain barrier and used as chemotherapy primarily to treat glioblastoma and other brain cancers.. Two men (aged 38 and 54 years) suddenly developed polyuria and polydispsia approximately four weeks after the initiation of temozolomide for a glioblastoma. Plasma and urine parameters demonstrated the presence of a urinary concentration defect.. The clinical and laboratory abnormalities completely resolved with intranasal desmopressin therapy, allowing the continuation of temozolomide. The disorder did not relapse after cessation of temozolomide and desmopressin and relapsed in one patient after rechallenge with temozolomide.. Our report highlights the importance of a quick recognition of this exceptional complication, in order to initiate promptly treatment with desmopressin and to maintain therapy with temozolomide.

Topics: Adult; Antineoplastic Agents, Alkylating; Brain Neoplasms; Deamino Arginine Vasopressin; Diabetes Insipidus, Neurogenic; Fatal Outcome; Glioblastoma; Humans; Male; Middle Aged; Temozolomide; Vasopressins

Changes in the clinical condition, CT scans and MRIs of patients with recurrent or inoperable astrocytomas and brain metastasis have been observed following treatment with a combination of vasopressin and corticoids. These changes have not been reported with corticoids alone--at least not over the short time reported for this therapy. Ten cases of grade II astrocytomas, seven cases of grade III or IV astrocytomas and six cases of metastasis of bronchial or breast origin were studied. To explain the results, it is proposed that vasopressin delays the 'escape' from the effects of corticoids alone and some facts and theories are recalled to help the reader understand the reasoning behind this explanation.

Topics: Adrenal Cortex Hormones; Adult; Antineoplastic Combined Chemotherapy Protocols; Astrocytoma; Brain Neoplasms; Female; Glioblastoma; Humans; Male; Middle Aged; Neoplasm Recurrence, Local; Retrospective Studies; Tomography, X-Ray Computed; Vasopressins

Topics: Adrenal Gland Diseases; Adrenocorticotropic Hormone; Aldosterone; Angiotensin II; Biological Assay; Brain Neoplasms; Bronchial Neoplasms; Central Nervous System Diseases; Child; Edema; Endocrine System Diseases; Glioblastoma; Humans; Male; Osmolar Concentration; Pituitary Diseases; Renin; Sodium Chloride; Vasopressins

Topics: Astrocytoma; Brain Neoplasms; Cysts; Epidermal Cyst; Glioblastoma; Humans; Hypothalamo-Hypophyseal System; Lymphoma, Large B-Cell, Diffuse; Meningioma; Neuroectodermal Tumors, Primitive, Peripheral; Oligodendroglioma; Pituitary Gland, Posterior; Vasopressins