Endocrine Abstracts

Background: The spectrum of polyuria-polydipsia syndrome (PPS) includes diabetes insipidus (central or nephrogenic) and primary polydipsia. In clinical practice the differential diagnosis particularly of central diabetes insipidus (cDI) and primary polydipsia (PP) is often difficult. The current gold standard – the water deprivation test (WDT) with or without vasopressin (AVP) measurements – lacks reliable diagnostic accuracy. Arginine infusion is known to stimulate ...

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 ...

Background: Hyponatremia is the most common electrolyte disorder in hospitalized patients with pneumonia. Different studies have shown an association of admission hyponatremia and worse in-hospital outcome, but no data are available about the impact of hyponatremia at discharge on outcome.Material and methods: Data from a double-blind randomized study including 725 patients hospitalized with community-acquired pneumonia were analyzed. The primary aim of ...

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: 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...