pituitrin and Remission--Spontaneous

Topics: Adult; Child; Drinking; Extracellular Space; Female; Humans; Hypernatremia; Hypothalamo-Hypophyseal System; Hypothalamus; Kidney Concentrating Ability; Male; Pennsylvania; Remission, Spontaneous; Sensory Receptor Cells; Sodium; Thirst; Vasopressins; Water-Electrolyte Balance

Septo-optic dysplasia (SOD) (De Morsier's syndrome) is a complex developmental disorder marked by variable and often incomplete formation of cranial midline structures, resulting in absence of the septum pellucidum, optic nerve hypoplasia, and hypothalamic-pituitary dysfunction. We describe a patient with SOD who manifested symptoms in the early neonatal period with severe deficiencies of multiple pituitary hormones including anti-diuretic hormone (ADH). Her congenital diabetic insipidus (DI), consequence of an anatomic defect, can be argued to be of the most severe type. Our patient resolved her severe DI 8 years after her initial presentation, suddenly requiring no further medical treatment for DI following longstanding pharmacological replacement of ADH. This is the first report of a patient with SOD with spontaneous resolution of congenital DI.

Topics: Child; Diabetes Insipidus; Female; Humans; Infant, Newborn; Magnetic Resonance Imaging; Pituitary Gland, Posterior; Remission, Spontaneous; Septo-Optic Dysplasia; Vasopressins

An elevation of the plasma antidiuretic hormone (ADH) levels has frequently been observed in Meniere's disease patients. However, little is known regarding the mechanism behind such an elevation of ADH level in Meniere's disease patients. Therefore, we measured the plasma ADH in Meniere's disease patients and other vertigo patients to elucidate the association between the ADH levels, stress levels and the development of Meniere's symptom.. The plasma ADH levels and plasma osmotic pressure were determined in 23 definite Meniere's disease patients and 160 patients with other types of vertigo/dizziness. All participants were administered questionnaire regarding their psychological status including their stress levels.. The ADH levels of Meniere's disease patients in the acute phase (5.80 +/- 1.37 pg/mL) were significantly higher in comparison with that of Meniere's disease patients in the remission phase (2.26 +/- 0.41 pg/mL) (P < 0.05). In other peripheral vertigo patients, the ADH level in the acute phase (1.71 +/- 0.23 pg/mL) was not significantly different from that in the remission phase (1.45 +/- 0.15 pg/mL). Meniere's disease patients in the acute phase had a significantly higher stress score (114 +/- 23) than Meniere's disease patients in the remission phase (56 +/- 13) (P < 0.05). However, there was no significant correlation between their stress score and the ADH levels.. These results suggest that the elevation of the plasma ADH levels in Meniere's disease patients in the acute phase is, therefore, associated with the pathogenesis of Meniere's disease attacks rather than with stress.

Topics: Acute Disease; Adult; Aged, 80 and over; Depression; Dizziness; Female; Humans; Life Change Events; Male; Meniere Disease; Middle Aged; Osmotic Pressure; Remission, Spontaneous; Sex Factors; Stress, Psychological; Vasopressins; Vertigo

A 38-year-old woman was admitted with severe thirst and polyuria at 31 weeks' gestation. The plasma concentration of vasopressin (AVP) was very low (0.73 pg/ml) under conditions of high plasma osmolality (316 mOsm/ kg). T1-weighted magnetic resonance (MR) images revealed enlargement of the pituitary posterior lobe with absence of the hyperintense signal. After delivery, restoration of the hyperintense signal was demonstrated. This depletion-repletion process, which reflects the decrease and increase in amount of neurosecretory granules, is recognized in the case of transient central diabetes insipidus during pregnancy. We consider that an increase in cystine-aminopeptidase (CAP) activity is implicated in the pathogenesis.

Topics: Adult; Diabetes Insipidus, Neurogenic; Female; Follow-Up Studies; Humans; Hyperplasia; Magnetic Resonance Imaging; Pituitary Gland, Posterior; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Pregnancy Trimester, Third; Remission, Spontaneous; Risk Assessment; Vasopressins

We report a case of central diabetes insipidus with spontaneous remission 8 months after clinical beginning of the disease. A 20 years-old man developed polydipsia and polyuria in October 1994. A water deprivation study showed a defect in the urine concentrating function, which was corrected by vasopressine. A Magnetic Resonance imaging of the skull revealed a thickening of the pituitary stalk. His condition was well controlled by nasal DDAVP administration and 6 months later patient reduced spontaneously medication dose without clinical worsening. 8 months after clinical beginning, patient has become completely free from the need for medication to control clinical symptoms and urine concentrating function, as demonstrated by a re-evaluation study with water deprivation. A control Magnetic Resonance showed the regression of stalk enlargement. The clinical and radiological features of this case are discussed.

Topics: Adult; Brain; Diabetes Insipidus; Humans; Magnetic Resonance Imaging; Male; Polyuria; Remission, Spontaneous; Renal Agents; Vasopressins

A 55-year-old male smoker developed polyuria and polydipsia in November 1983. A water deprivation study revealed a defect in the urine concentrating function, which was corrected by vasopressin. Plasma antidiuretic hormone (ADH) was not increased by smoking. His condition was well controlled by deamino-D-arginine vasopressin. However, since February 1992 he has become completely free from the need for medication to control his urine volume. Re-evaluation studies with water deprivation and smoking revealed dramatic improvements in the urine concentrating function and ADH response. A patient with idiopathic diabetes insipidus with spontaneous remission after 8 years is reported.

Topics: Diabetes Insipidus; Humans; Male; Middle Aged; Remission, Spontaneous; Vasopressins; Water Deprivation

The very rare occurrence of an ADH-producing small cell carcinoma of the lung in a 52 year old male patient with cranial diabetes insipidus since childhood is described. In this case diabetes insipidus disappeared concomitantly with development of lung cancer and re-appeared with shrinkage of the lung tumour by radiation therapy. Further progressive expansion of the primary and metastatic tumours induced the syndrome of inappropriate ADH secretion once again (SIADH). This deterioration in the clinical course was reflected in the plasma levels of ADH and neurophysins. The existence of vasopressin in the tumour tissue was also demonstrated by means of an immunohistochemical staining technique combined with anti-vasopressin serum.

Topics: Carcinoma, Small Cell; Diabetes Insipidus; Humans; Inappropriate ADH Syndrome; Lung Neoplasms; Male; Middle Aged; Neurophysins; Remission, Spontaneous; Vasopressins

Post-traumatic diabetes insipidus was observed in 14 among 702 patients with severe trauma. The cause of the abnormal vasopressin secretion may be cerebral oedema, cerebral contusion near the hypothalamus, pull on the hypophyseal stalk by displacement or gross destruction of the brainstem. The hormonal hypofunction disappears once the cerebral damage has regressed. Treatment consists of exact balancing of water and electrolyte loss, using salt-free solutions. Drug treatment with vasopressin and with ADH-secretion stimulators has given unsatisfactory results, but should be used. Seven of the 14 patients died of their injuries. The symptoms of the diabetes insipidus syndrome regressed in the survivors.

Topics: Adult; Brain Concussion; Brain Edema; Brain Injuries; Brain Stem; Child; Diabetes Insipidus; Female; Humans; Male; Middle Aged; Remission, Spontaneous; Vasopressins

Topics: Adult; Aged; Bone Neoplasms; Breast Neoplasms; Female; Humans; Lymphatic Metastasis; Mathematics; Methylprednisolone; Middle Aged; Models, Biological; Neoplasm Metastasis; Palliative Care; Remission, Spontaneous; Time Factors; Vasopressins

Topics: Diabetes Insipidus; Humans; Remission, Spontaneous; Vasopressins

Topics: Adrenal Cortex Hormones; Adult; Astrocytoma; Brain Neoplasms; Drug Synergism; Female; Follow-Up Studies; Humans; Male; Middle Aged; Neoplasm Recurrence, Local; Remission, Spontaneous; Vasopressins