Endocrine Abstracts

Introduction: Gonadotroph adenomas usually present as clinically non-functioning sellar masses. They are extremely infrequent in children. Only some case report of children and adolescents with clinical manifestations of high serum gonadotrophin levels have been published. As in adult patients most of the gonadotroph adenomas have a silent growth, and therefore a late presentation as macroadenoma with mass effects.Case report: This 16-year-old girl prese...

Introduction: Hyponatremia due to excessive fluid intake (i.e. primary polydipsia (PP)) is common. It may culminate in profound hyponatremia – carrying considerable risk of morbidity. However, data on patients with PP leading to hyponatremia is largely lacking. Herein, we describe the characteristics of polydipsic patients hospitalised with profound hyponatremia, and assess one-year outcomes.Method: In this prospective observational study, we includ...

Background: It is controversial whether the attenuated increase of circulating cortisol to ACTH stimulation predicts treatment response to corticosteroids in patients with critical illness. We investigated whether ACTH testing predicts treatment response to corticosteroids in patients with community-acquired pneumonia (CAP).Methods: We performed a low dose (1 μg) ACTH test on admission in a prospective randomised, double-blind, placebo-controlled mu...

Introduction: Fluid restriction (FR) is often the recommended first-line treatment for hyponatremia due to the syndrome of inappropriate antidiuresis (SIAD). However, FR not always leads to successful correction of hyponatremia, making predictive markers of treatment response desirable. The aim of this study was to evaluate routinely measured laboratory parameters, copeptin and pro-atrial natriuretic peptide (pro-ANP) as possible predictors of treatment success to FR.<p cl...

Background: Glucocorticoids are frequently prescribed in inflammatory diseases. We investigated the influence of prednisone on classical and novel inflammatory markers in community-acquired pneumonia (CAP).Methods: We evaluated levels of C-reactive protein (CRP), procalcitonin, leukocyte and neutrophil count in a prospective randomized, double-blind, placebo-controlled multicenter trial which compared prednisone 50 mg for 7 days to placebo in patients ho...

Background: The water deprivation test as the accepted gold standard in the differential diagnosis of polyuria polydipsia syndrome can be associated with a decrease in extracellular fluid volume in patients with diabetes insipidus (DI). We herein evaluated mid-regional pro-atrial natriuretic peptide (MR-proANP) as marker of extracellular body volume in patients with diabetes insipidus compared to primary polydipsia (PP), at baseline and after water deprivation.<p class="ab...

Introduction: The correct differential diagnosis of the disorders related to polyuria–polydipsia syndrome (PPS) is mandatory since inadequate treatment may lead to serious complications. The diagnostic gold standard is the water deprivation test (WDT) with direct or indirect measurement of plasma vasopressin (AVP). But test interpretation is problematic, and direct measurement of AVP is hampered by methodological difficulties. The aim of this study was to evaluate the dia...

Background: Hyponatremia is common in hospitalized patients and its differential diagnosis and management challenging. An important mechanism is suppressed or adequately or inadequately secreted plasma arginine vasopressin (AVP). Therefore, plasma vasopressin levels may help in the differential diagnosis and in therapy management. Copeptin is secreted in an equimolar ratio to AVP and is more reliable to measure.Methods: In this prospective observational ...

Background: Hyponatremia is the most common electrolyte disturbance in hospitalized patients and associated with a substantial morbidity and mortality. Symptoms of severe hyponatremia vary among patients between nonspecific symptoms such as nausea or malaise or acute life threatening brain oedema. Prospective studies to assess symptoms and mortality in patients with severe hyponatremia are lacking.Methods: In this prospective multicentre observational st...

Introduction: Postoperative diabetes insipidus (DI) remains a common complication after pituitary surgery. AVP measurement might contribute to a straightforward diagnosis, though, its measurement is cumbersome. Copeptin, the stable C-terminal glycopeptide of the AVP prohormone, is a reliable surrogate of AVP.We aimed to elucidate whether copeptin is a helpful marker in the diagnostic approach of postoperative DI.Methods/design: Pro...