Journal Article Epublish
PubMed: 42835423 DOI: 10.1210/jendso/bvag211
Late recovery from chronic arginine vasopressin deficiency: a multicenter retrospective case-control study.
J Endocr Soc 10(10):bvag211
Authors: Clara O Sailer, Francesca Galbiati, Anna Aulinas, Maged Muhammed, Regine Boutin, Jenna Bourassa, Cihan Atila, Julia Crowley, Allie Dayno, Hannah Pearlstein, Lisa B Nachtigall, Karen K Miller, Nicholas A Tritos, Ursula B Kaiser, Shana E McCormack, Mirjam Christ-Crain, Laura E Dichtel, Elizabeth A Lawson
Affiliations
- Section of Neuroendocrinology and Reproduction, Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Mass General Brigham, Harvard Medical School, Boston, MA 02114, USA. Mass General Brigham Pituitary Center, Mass General Brigham, Boston, MA 02114, USA.
- Department of Endocrinology and Nutrition, Hospital de la Santa Creu i Sant Pau, EndoERN, IR-Sant Pau, CIBERER Unidad 747 (ISCIII), 08041 Barcelona, Spain. Faculty of Medicine, University of Vic-Central University of Catalonia, 08500 Vic, Spain.
- Section of Neuroendocrinology and Reproduction, Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Mass General Brigham, Harvard Medical School, Boston, MA 02114, USA.
- Mass General Brigham Pituitary Center, Mass General Brigham, Boston, MA 02114, USA.
- Department of Endocrinology, Diabetology and Metabolism, University Hospital Basel, University of Basel, 4031 Basel, Switzerland.
- Neuroendocrine Center, Division of Endocrinology and Diabetes, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
Abstract
CONTEXT
Arginine vasopressin deficiency (AVP-D), caused by hypothalamic/pituitary damage from tumor or surgery, can be transient or chronic. Chronic AVP-D is thought to be permanent though emergent research indicates the possibility of late recovery. Little is known about clinical characteristics that predict late recovery from chronic AVP-D.
OBJECTIVE
Describe characteristics associated with late recovery from chronic AVP-D.
DESIGN
Multicenter, retrospective case-control study of AVP-D Recovered (n = 18) vs AVP-D Non-recovered (n = 36; matched for sex and disease duration).
MAIN OUTCOME MEASURES
Clinical characteristics assessed at hypothalamic/pituitary disease diagnosis, AVP-D diagnosis, AVP-D recovery, and most recent clinical evaluation. We also present characteristics of three pediatric cases with AVP-D recovery.
RESULTS
At diagnosis of hypothalamic/pituitary disease, AVP-D Recovered, compared to AVP-D Non-recovered, were older (45 ± 19 vs 33 ± 13 years, P = .006) and more likely to have functioning pituitary tumors (33.3% vs 8.3%, P = .05). Following diagnosis of AVP-D, AVP-D Recovered received lower total daily doses of desmopressin (100 [IQR; 50, 100] vs 200 [100, 200] µg oral or equivalent, P = .01). Recovery occurred after a median of 6.3 years [1.7, 12.0] and occurred earlier in those without hypothyroidism (P = .049) or adrenal insufficiency at diagnosis of AVP-D (P = .008).
CONCLUSION
Our study supports the notion that chronic AVP-D may not be permanent across the lifespan. Continued requirement for desmopressin, particularly in those with a history of functioning pituitary tumors, low doses of desmopressin, and without concurrent hypothyroidism or adrenal insufficiency at diagnosis, should be regularly reassessed.
MeSH
Arginine Vasopressin, Diabetes Insipidus, Neurogenic, Adrenal Insufficiency, Deamino Arginine Vasopressin, Pituitary Diseases, Arginine, Case-Control Studies, Neoplasms, Recycling, Hypothyroidism, Diagnosis, Pituitary Neoplasms