Endocrine Abstracts

Background: The differential diagnosis of hyponatremia is often challenging because of its association with multiple underlying pathophysiological mechanisms, diseases and treatment options. Several algorithms are available in order to guide the diagnostic approach to hyponatremia, but their diagnostic and clinical utility has never been evaluated. We aimed to assess in detail the diagnostic utility as well the limitations of the existing approaches to hyponatremia.<p clas...

Background: The syndrome of inappropriate antidiuresis (SIAD) is the most frequent cause of hyponatremia. Its diagnosis requires a decreased serum osmolality, urinary osmolality >200 mosm/kg, clinical euvolemia, and urinary sodium (UNa) >30 mmol/l. The natriuretic effect of diuretics impairs the diagnostic accuracy of UNa and thus, limits the diagnostic and therapeutic decision in hyponatremic patients substantially. We therefore examined the accuracy to predict SIAD o...

Context: Osmotic stimulus or stress results in release of vasopressin. Animal studies have shown that inflammatory parameters such as interleukin-6 (IL-6) and interleukin-8 (IL-8) increase in parallel, mainly in central brain regions. Whether osmotic stimulation leads to an inflammatory response in humans is unknown. We therefore investigated the influence of osmotic stimulation on the inflammatory system in healthy volunteers.Method: In this prospective...

Context: Hyponatremia due to the syndrome of inappropriate antidiuretic hormone secretion (SIADH) is a very common condition in hospitalized patients. It is crucial to establish the cause of SIADH especially in order to exclude or detect an underlying malignancy. As SIADH can be caused by paraneoplastically produced arginine vasopressin (AVP), we hypothesized that its stable surrogate marker copeptin may be used as a diagnostic tool.Methods: We analyzed ...

Introduction: Onset of hyperkalemia has previously been reported during the administration of hypertonic resuscitation solutions. Since the hypertonic saline infusion test has recently been validated for the diagnosis of diabetes insipidus, we aimed to investigate the course of plasma potassium levels during the test.Material and Methods: Data of 144 patients undergoing osmotic stimulation with hypertonic saline infusion at 11 tertiary medical centres in...

Background: Arginine vasopressin (AVP) is released upon osmotic stimulation or hypovolemia in order to maintain water balance. A recent study showed a role of AVP in haematopoiesis by stimulating red blood cell precursors, suggesting a higher risk of anaemia in patientis with AVP deficiency. The aim of this study was to explore the effect of low AVP levels in patients with central diabetes insipidus (cDI) and primary polydipsia (PP) on haemoglobin and the prevalence of anaemia...

Background: Copeptin is the C-terminal portion of the precursor of vasopressin. In contrast to vasopressin copeptin is stable in vitro and easy to measure. Similar kinetics of both peptides have been described in different trials. However, the physiological area of normality of copeptin has never been evaluated.Methods: We measured plasma copeptin, sodium, and osmolality levels in 93 healthy volunteers at baseline, during/after i.v. infusion of ...

Introduction: The syndrome of inappropriate antidiuresis (SIADH) is the most common cause of hypoosmolality. Ectopic AVP hypersecretion has long been considered as the primaryn mechanism of SIADH. But different types of osmoregulatory defect in AVP release have been described in this disorder. A comprehensive characterization of these different forms of SIADH in a large cohort of patients may provide important new insights into the still incompletely understood pathophysiology...

Introduction: Surgery is the established first line treatment in adrenocortical carcinoma (ACC). For benign adrenal tumours, laparoscopic adrenalectomy (LA) has become the treatment of choice. However, the role of LA in ACC remains highly controversial. Data from the German ACC Registry were used to evaluate the technical feasibility of LA in ACC and to compare the long-term outcome after LA with the results of open adrenalectomy (OA).Methods: Out of 521...

Poor agreement between different analytical methods measuring aldosterone concentrations impedes applicability of uniform cut-offs in the diagnostic work-up of primary aldosteronism (PA). We compared 4 analytical methods (2 immunoassays and 2 LC-MS/MS) in plasma samples before and after saline infusion test (SIT). 80 hypertensive patients underwent the standardized diagnostic work-up within the German Conn’s registry. Patients (PA n=39/non-PA n=41) were ...