Subclinical diabetes insipidus

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• 作者：Antonio Bellastella ; Antonio Bizzarro ; Caterina Colella ; Giuseppe Bellastella ; Antonio A. Sinisi ; Annamaria De Bellis
• 关键词：subclinical central diabetes insipidus ; autoimmunity ; AVPcAb ; isohormonal therapy
• 刊名：Best Practice Research Clinical Endocrinology Metabolism
• 出版年：2012
• 出版时间：August, 2012
• 年：2012
• 卷：26
• 期：4
• 页码：471-483
• 全文大小：380 K

文摘

Subclinical central diabetes insipidus (CDI) can be the outcome of a number of diseases that affect the hypothalamus-infundibulum-post hypophysis axis. One of the most common forms of subclinical CDI is linked to an autoimmune pathogenesis even if other causes may be also responsible. Among these, pregnancy, traumatic and surgical brain injury and some infiltrative, vascular, infectious and neoplastic diseases have been reported with increasing frequency.

The natural history of autoimmune CDI seems to evolve through 4 functional stages according to the presence of antibodies to vasopressin-secreting cells (AVPcAb) and the relationship between their behavior overtime, the variations of posterior pituitary function and the characteristics of hypothalamic-hypophyseal region on magnetic resonance imaging. This staging is of crucial importance for the therapeutic strategy, taking into account that some stages could be still reversible. Several medical treatments have been suggested to interrupt the progression toward clinical CDI but the results are still discussed.