title: Diabetes insipidus--diagnosis and management.
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.
authors.affiliation: Department of Pediatrics, IRCCS G. Gaslini, University of Genoa, Largo Gerolamo Gaslini 5, Genoa, Italy.
authors.forename: Natascia
authors.initials: N
authors.lastname: Di Iorgi
authors.forename: Flavia
authors.initials: F
authors.lastname: Napoli
authors.forename: Anna Elsa Maria
authors.initials: AE
authors.lastname: Allegri
authors.forename: Irene
authors.initials: I
authors.lastname: Olivieri
authors.forename: Enrica
authors.initials: E
authors.lastname: Bertelli
authors.forename: Annalisa
authors.initials: A
authors.lastname: Gallizia
authors.forename: Andrea
authors.initials: A
authors.lastname: Rossi
authors.forename: Mohamad
authors.initials: M
authors.lastname: Maghnie
mesh_terms: D000328:Adult; D000367:Age Factors; D000818:Animals; D050034:Antidiuretic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D002648:Child; D003894:Deamino Arginine Vasopressin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D003919:Diabetes Insipidus / Q000175:diagnosis* / Q000209:etiology / Q000235:genetics / Q000628:therapy*; D018500:Diabetes Insipidus, Nephrogenic / Q000175:diagnosis / Q000209:etiology / Q000235:genetics / Q000628:therapy; D020790:Diabetes Insipidus, Neurogenic / Q000175:diagnosis / Q000209:etiology / Q000235:genetics / Q000628:therapy; D016903:Drug Monitoring; D005440:Fluid Therapy; D006801:Humans; D007223:Infant
chemical_list: D050034:Antidiuretic Agents; D003894:Deamino Arginine Vasopressin