Diabetes insipidus - Diagnosis and management

Natascia Di Iorgi, Flavia Napoli, Anna Elsa Maria Allegri, Irene Olivieri, Enrica Bertelli, Annalisa Gallizia, Andrea Rossi, Mohamad Maghnie

Research output: Contribution to journalArticlepeer-review

Abstract

Central diabetes insipidus (CDI) is the end result of a number of conditions that affect the hypothalamic-neurohypophyseal system. The known causes include germinoma/craniopharyngioma, Langerhans cell histiocytosis (LCH), local inflammatory, autoimmune or vascular diseases, trauma resulting from surgery or an accident, sarcoidosis, metastases and midline cerebral and cranial malformations. In rare cases, the underlying cause can be genetic defects in vasopressin synthesis that are inherited as autosomal dominant, autosomal recessive or X-linked recessive traits. The diagnosis of the underlying condition is challenging and raises several concerns for patients and parents as it requires long-term follow-up. Proper etiological diagnosis can be achieved via a series of steps that start with clinical observations and then progress to more sophisticated tools. Specifically, MRI identification of pituitary hyperintensity in the posterior part of the sella, now considered a clear marker of neurohypophyseal functional integrity, together with the careful analysis of pituitary stalk shape and size, have provided the most striking findings contributing to the diagnosis and understanding of some forms of 'idiopathic' CDI. MRI STIR (short-inversion-time inversion recovery sequencing) is a promising technology for the early identification of LCH-dependent CDI.

Original languageEnglish
Pages (from-to)69-84
Number of pages16
JournalHormone Research in Paediatrics
Volume77
Issue number2
DOIs
Publication statusPublished - Apr 2012

Keywords

  • Central diabetes insipidus
  • Langerhans cell histiocytosis
  • Pituitary stalk
  • Vasopressin

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Pediatrics, Perinatology, and Child Health

Fingerprint Dive into the research topics of 'Diabetes insipidus - Diagnosis and management'. Together they form a unique fingerprint.

Cite this