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Rinkoo Dalan – One of the best experts on this subject based on the ideXlab platform.

Christopher J. Thompson – One of the best experts on this subject based on the ideXlab platform.

  • Adipsic diabetes insipidus in adult patients
    Pituitary, 2017
    Co-Authors: Martin Cuesta, Mark J Hannon, Christopher J. Thompson
    Abstract:

    Introduction Adipsic diabetes insipidus (ADI) is a very rare disorder, characterized by hypotonic polyuria due to arginine vasopressin (AVP) deficiency and failure to generate the sensation of thirst in response to hypernatraemia. As the sensation of thirst is the key homeostatic mechanism that prevents hypernatraemic dehydration in patients with untreated diabetes insipidus (DI), Adipsia leads to failure to respond to aquaresis with appropriate fluid intake. This predisposes to the development of significant hypernatraemia, which is the typical biochemical manifestation of adipsic DI. Methods A literature search was performed to review the background, etiology, management and associated complications of this rare condition. Results ADI has been reported to occur in association with clipping of an anterior communicating arteartery aneurysm following subarachnoid haemorrhage, major hypothalamic surgery, traumatic brain injury and toluene exposure among other conditions. Management is very difficult and patients are prone to marked changes in plasma sodium concentration, in particular to the development of severe hypernatraemia. Associated hypothalamic disorders, such as severe obesity, sleep apnoea and thermoregulatory disorders are often observed in patients with ADI. Conclusion The management of ADI is challenging and is associated with significant morbidity and mortality. Prognosis is variable; hypothalamic complications lead to early death in some patients, but recent reports highlight the possibility of recovery of thirst.

  • Adipsic diabetes insipidus in adult patients.
    Pituitary, 2017
    Co-Authors: Martin Cuesta, Mark J Hannon, Christopher J. Thompson
    Abstract:

    Introduction Adipsic diabetes insipidus (ADI) is a very rare disorder, characterized by hypotonic polyuria due to arginine vasopressin (AVP) deficiency and failure to generate the sensation of thirst in response to hypernatraemia. As the sensation of thirst is the key homeostatic mechanism that prevents hypernatraemic dehydration in patients with untreated diabetes insipidus (DI), Adipsia leads to failure to respond to aquaresis with appropriate fluid intake. This predisposes to the development of significant hypernatraemia, which is the typical biochemical manifestation of adipsic DI.

  • clinical insights into adipsic diabetes insipidus a large case series
    Clinical Endocrinology, 2007
    Co-Authors: Rachel K Crowley, M Sherlock, Amar Agha, Diarmuid Smith, Christopher J. Thompson
    Abstract:

    Summary Objective  Adipsic diabetes insipidus (DI) causes significant hypernatraemia. Morbidity and mortality data for patients with adipsic DI have been previously published as single case reports, rather than as formal trials or case series from units with established management protocols. Our objective was to describe morbidity and mortality in patients with adipsic DI attending a tertiary referral centre, representing the largest reported series of adipsic DI, and to suggest management protocols for such patients, based on our extensive experience of this condition. Design  Arginine vasopressin (AVP) responses to hypotension were recorded during trimetaphan infusion. Sleep abnormalities were identified using overnight oximetry or polysomnography. Case-note analysis defined other clinical abnormalities including seizures and thrombotic episodes. Important clinical points for the management of these patients are highlighted. Patients  Thirteen patients with adipsic DI defined by thirst and plasma AVP responses to hypertonic saline infusion. Results  All patients had absent AVP and thirst responses to osmotic stimulation, with subnormal water intake. Five patients had absent AVP responses to hypotension; the remainder had normal responses. Eight patients were obese [body mass index (BMI) > 30 kg/m2], and three were overweight (BMI > 25 kg/m2). Seven patients had sleep apnoea, of whom three died at 36 years or younger. Four patients developed venous thrombosis during episodes of hypernatraemia. Two patients had thermoregulatory dysfunction and seven patients had seizure activity. Conclusion  Adipsic DI is associated with significant morbidity and mortality. Physicians should be aware of associated, treatable hypothalamic abnormalities such as obesity, sleep apnoea, seizures and thermoregulatory disorders when managing adipsic DI.

Ikuo Yamamori – One of the best experts on this subject based on the ideXlab platform.

  • Adipsia increases risk of death in patients with central diabetes insipidus
    Endocrine Journal, 2014
    Co-Authors: Hiroshi Arima, Toshihiko Wakabayashi, Tetsuya Nagatani, Masazumi Fujii, Akihiro Hirakawa, Takashi Murase, Yuko Yambe, Tsutomu Yamada, Fumiko Yamakawa, Ikuo Yamamori
    Abstract:

    Central diabetes insipidus (CDI) is caused by deficiency of arginine vasopressin, an antidiuretic hormone. Patients with CDI manifest polyuria which is usually compensated for by increases in water intake. However, some patients are not able to sense thirst due to the destruction of osmoreceptors in the hypothalamus. These adipsic CDI patients are easily dehydrated and the consequent dehydration could be life-threatening. The objective of this study was to investigate the prognosis of adipsic CDI patients. We have reviewed 149 patients with CDI in three hospitals using databases of the electronic medical recording systems, and examined whether Adipsia could affect the morbidity and mortality in CDI patients with multivariable analyses. Twenty-three patients with CDI were adipsic while the remaining 126 patients were non-adipsic. The multivariate analyses showed that the incidence of serious infections which required hospitalization was significantly higher in the adipsic CDI patients compared to that in non-adipsic CDI patients (p <0.001). A total of 6 patients with CDI died during the follow-up (median duration; 60 months, range 1 to 132 months). Four of them were adipsic, three of whom died of infection. The statistical analyses revealed that the risk of death in adipsic CDI patients was significantly higher than in non-adipsic patients (p =0.007). It is thus suggested that adipsic CDI patients were susceptible to serious infections which could be the causes of death.

  • Adipsia increases risk of death in patients with central diabetes insipidus
    Endocrine journal, 2013
    Co-Authors: Hiroshi Arima, Toshihiko Wakabayashi, Tetsuya Nagatani, Masazumi Fujii, Akihiro Hirakawa, Takashi Murase, Yuko Yambe, Tsutomu Yamada, Fumiko Yamakawa, Ikuo Yamamori
    Abstract:

    Central diabetes insipidus (CDI) is caused by deficiency of arginine vasopressin, an antidiuretic hormone. Patients with CDI manifest polyuria which is usually compensated for by increases in water intake. However, some patients are not able to sense thirst due to the destruction of osmoreceptors in the hypothalamus. These adipsic CDI patients are easily dehydrated and the consequent dehydration could be life-threatening. The objective of this study was to investigate the prognosis of adipsic CDI patients. We have reviewed 149 patients with CDI in three hospitals using databases of the electronic medical recording systems, and examined whether Adipsia could affect the morbidity and mortality in CDI patients with multivariable analyses. Twenty-three patients with CDI were adipsic while the remaining 126 patients were non-adipsic. The multivariate analyses showed that the incidence of serious infections which required hospitalization was significantly higher in the adipsic CDI patients compared to that in non-adipsic CDI patients (p

Karen Suigeok Chua – One of the best experts on this subject based on the ideXlab platform.

  • adipsic diabetes insipidus the challenging combination of polyuria and Adipsia a case report and review of literature
    Frontiers in Endocrinology, 2019
    Co-Authors: Rinkoo Dalan, Hanxin Chin, Jeremy K M Hoe, Abel Weiliang Chen, Huiling Tan, Bernhard O Boehm, Karen Suigeok Chua
    Abstract:

    Adipsic Diabetes Insipidus is a rare hypothalamic disorder characterized by a loss of thirst in response to hypernatraemia accompanied by diabetes insipidus. These occur secondary to a congregation of defects in the homeostatic mechanisms of water balance. A 27-year old Chinese female presented with Adipsic Diabetes Insipidus after cerebral arteriovenous malformation (AVM) surgery. Initial diagnosis and management was extremely challenging. Long term management required a careful interplay between low dose vasopressin analog treatment and fluids. Detailed charts of medication and sodium balance are described in the case presentation. We performed a literature search of similarly reported cases and describe the possible pathogenesis, etiology, clinical presentation, acute and chronic management, and prognosis.

  • adipsic diabetes insipidus the challenging combination of polyuria and Adipsia a case report and review of literature
    Frontiers in Endocrinology, 2019
    Co-Authors: Rinkoo Dalan, Hanxin Chin, Abel Weiliang Chen, Bernhard O Boehm, Karen Suigeok Chua
    Abstract:

    Adipsic Diabetes Insipidus is a rare hypothalamic disorder characterised by a loss of thirst in response to hypernatraemia accompanied by diabetes insipidus. These occur secondary to a congregation of defects in the homeostatic mechanisms of water balance. A 27-year old Chinese female presented with Adipsic Diabetes Insipidus after cerebral arteriovenous malformation (AVM) surgery. Initial diagnosis and management was extremely challenging. Long term management required a careful interplay between low dose vasopressin analogue treatment and fluids. Detailed charts of medication and sodium balance are described in the case presentation. We performed a literature search of similarly reported cases and describe the possible pathogenesis, aetiology, clinical presentation, acute and chronic management and prognosis.

Bernhard O Boehm – One of the best experts on this subject based on the ideXlab platform.

  • adipsic diabetes insipidus the challenging combination of polyuria and Adipsia a case report and review of literature
    Frontiers in Endocrinology, 2019
    Co-Authors: Rinkoo Dalan, Hanxin Chin, Jeremy K M Hoe, Abel Weiliang Chen, Huiling Tan, Bernhard O Boehm, Karen Suigeok Chua
    Abstract:

    Adipsic Diabetes Insipidus is a rare hypothalamic disorder characterized by a loss of thirst in response to hypernatraemia accompanied by diabetes insipidus. These occur secondary to a congregation of defects in the homeostatic mechanisms of water balance. A 27-year old Chinese female presented with Adipsic Diabetes Insipidus after cerebral arteriovenous malformation (AVM) surgery. Initial diagnosis and management was extremely challenging. Long term management required a careful interplay between low dose vasopressin analog treatment and fluids. Detailed charts of medication and sodium balance are described in the case presentation. We performed a literature search of similarly reported cases and describe the possible pathogenesis, etiology, clinical presentation, acute and chronic management, and prognosis.

  • adipsic diabetes insipidus the challenging combination of polyuria and Adipsia a case report and review of literature
    Frontiers in Endocrinology, 2019
    Co-Authors: Rinkoo Dalan, Hanxin Chin, Abel Weiliang Chen, Bernhard O Boehm, Karen Suigeok Chua
    Abstract:

    Adipsic Diabetes Insipidus is a rare hypothalamic disorder characterised by a loss of thirst in response to hypernatraemia accompanied by diabetes insipidus. These occur secondary to a congregation of defects in the homeostatic mechanisms of water balance. A 27-year old Chinese female presented with Adipsic Diabetes Insipidus after cerebral arteriovenous malformation (AVM) surgery. Initial diagnosis and management was extremely challenging. Long term management required a careful interplay between low dose vasopressin analogue treatment and fluids. Detailed charts of medication and sodium balance are described in the case presentation. We performed a literature search of similarly reported cases and describe the possible pathogenesis, aetiology, clinical presentation, acute and chronic management and prognosis.