scholarly journals Central Diabetes Insipidus in an Extremely-Low-Birth-Weight Preterm Infant with Suspected Ectopic Posterior Lobe of the Pituitary Gland

2020 ◽  
Vol 27 (1) ◽  
pp. 31-36
Author(s):  
Yung Zu Park ◽  
Inseong Hwang ◽  
Sung-Ha Kim ◽  
Sook Min Hwang ◽  
Tae-Jung Sung ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Pituitary Gland ◽  
Diabetes Insipidus ◽  
Preterm Infant ◽  
Central Diabetes Insipidus ◽  
Extremely Low Birth Weight ◽  
Posterior Lobe

Hypo-pharyngeal distension in an extremely low birth weight preterm infant

2015 ◽  
Vol 100 (6) ◽  
pp. F500-F500 ◽  
Author(s):  
B Sinha ◽  
I Castro-Aragon ◽  
E M Wachman ◽  
A M Fujii ◽  
B M Levesque
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Preterm Infant ◽  
Extremely Low Birth Weight

scholarly journals Central diabetes insipidus: alert for dehydration in very low birth weight infants during the neonatal period. A case report

2014 ◽  
Vol 133 (1) ◽  
pp. 60-63 ◽  
Author(s):  
Maria Lúcia Silveira Ferlin ◽  
Débora Simone Sales ◽  
Fábia Pereira Martins Celini ◽  
Carlos Eduardo Martinelli Junior
Keyword(s):  
Case Report ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Diabetes Insipidus ◽  
Very Low Birth Weight ◽  
Neonatal Period ◽  
Central Diabetes Insipidus ◽  
Low Birth Weight Infants ◽  
Normal Fluid ◽  
Fluid Supply

CONTEXT: Central diabetes insipidus (CDI) is a rare cause of hypernatremia during the neonatal period. The diagnosis is particularly difficult in very low birth weight (VLBW) newborns. CASE REPORT: We report on a preterm newborn who presented CDI soon after birth. On the third day of life, signs of dehydration were present despite normal fluid supply. The diuresis rate was 4.4 ml/kg/h. Although the fluid supply was then increased, the dehydration continued, with hypernatremia, normal glycemia, diuresis of 7.4 ml/kg/h and urine density of 1005 mOsmol/l. Thus, a diagnostic hypothesis of diabetes insipidus was raised. A test with a nasal vasopressin analogue (dDAVP) was performed and CDI was confirmed. Reduction of the fluid supply became possible through appropriate treatment. CONCLUSION: The diagnosis of CDI is rarely made during the neonatal period, especially in VLBW newborns, because of the difficulty in detecting elevated diuresis. Persistent hypernatremia, usually accompanied by hyperthermia despite abundant fluid supply, weight loss and low urine osmolality are important signs of alert.

Pontine Tegmental Cap Dysplasia in an Extremely Low Birth Weight Preterm Infant

2015 ◽  
Vol 46 (S 01) ◽  
Author(s):  
S. Picker-Minh ◽  
S. Hartenstein ◽  
H. Proquitté ◽  
S. Fröhler ◽  
V. Raile ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Preterm Infant ◽  
Extremely Low Birth Weight

scholarly journals Pituitary Metastasis Presenting With Central Diabetes Insipidus and Panhypopituitarism

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A601-A601
Author(s):  
Donna Lee ◽  
Preeti Kishore
Keyword(s):  
Pituitary Gland ◽  
Diabetes Insipidus ◽  
Reference Range ◽  
Anterior Lobe ◽  
Central Diabetes Insipidus ◽  
Axillary Lymph ◽  
Posterior Lobe ◽  
Primary Tumors ◽  
Laboratory Results ◽  
Metastatic Involvement

Abstract Background: Metastatic involvement of the pituitary gland and infundibular stalk is rare, accounting for about 2% of all diagnosed pituitary masses. Although primary tumors from almost every organ have been reported, breast and lung cancers are the most common primary tumors to metastasize to the pituitary gland. The clinical presentation varies and can include headache, visual impairment, diabetes insipidus, and panhypopituitarism. The posterior lobe of the pituitary is more susceptible to metastatic involvement than the anterior lobe due to its direct blood supply from the systemic circulation, whereas the anterior lobe is supplied by the hypophyseal portal system. Additionally, the smaller posterior lobe can be destroyed with less metastatic volume, allowing for earlier manifestation of symptoms. Clinical Case: An 81-year-old woman with a history of Stage IIA ER+ IDC of the left breast status post lumpectomy and axillary lymph node dissection in 1999 followed by mastectomy in 2009 due to local recurrence presented with confusion for two weeks. At the time, she had known lung metastases and was on palliative chemotherapy. CT head showed a 1.8 cm and 2.3 cm calvarial lytic lesion in the right occipital bone and at the vertex, respectively. MRI brain/pituitary revealed a well-circumscribed, enhancing suprasellar mass measuring 9 x 10 mm likely involving the pituitary infundibulum and hypothalamus with mass effect on the optic chiasm. Laboratory results were consistent with secondary adrenal insufficiency, central hypothyroidism, and hypogonadotropic hypogonadism. Prolactin was mildly elevated due to stalk effect. The patient also had hypernatremia and inappropriately low urine osmolality, which nearly tripled after administration of desmopressin, confirming central diabetes insipidus. She was subsequently started on hydrocortisone, levothyroxine, and desmopressin. Laboratory Results: Prolactin 30.47 (reference range 4.79-23.3 mIU/mL), IGF-1 88 (17-193 ng/mL), 7am ACTH 3.4 (7.2-63.3 pg/mL), 7am cortisol 0.6 (6.2-29 µg/dL), TSH 3.03 (0.47-6.9 U/L), FT4 0.351 (0.75-2 ng/dL), FSH 0.2 (25.8-134.8 mIU/mL), LH <0.1 (7.7-58.5 mIU/mL), estradiol <5 (5-138 pg/mL); before desmopressin: Na 154 (reference range 135-145 mEq/L), urine osm 162 (50-1,200 mOsm/kg); after desmopressin: Na 143 (reference range 135-145 mEq/L), urine osm 469 (50-1,200 mOsm/kg) Conclusion: While pituitary metastases remain rare, their prevalence is expected to increase due to more sensitive biochemical tests and imaging techniques coupled with advances in cancer therapy that help patients with metastatic disease live longer. Interesting in our case is the patient’s age, which is significantly older than the median age reported in the literature, and her presentation with total anterior and posterior pituitary insufficiency after a prolonged oncologic course marked by progression of disease.

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