title: Subclinical diabetes insipidus.
abstract: Subclinical central diabetes insipidus (CDI) can be the outcome of a number of diseases that affect the hypothalamus-infundibulum-post hypophysis axis. One of the most common forms of subclinical CDI is linked to an autoimmune pathogenesis even if other causes may be also responsible. Among these, pregnancy, traumatic and surgical brain injury and some infiltrative, vascular, infectious and neoplastic diseases have been reported with increasing frequency. The natural history of autoimmune CDI seems to evolve through 4 functional stages according to the presence of antibodies to vasopressin-secreting cells (AVPcAb) and the relationship between their behavior overtime, the variations of posterior pituitary function and the characteristics of hypothalamic-hypophyseal region on magnetic resonance imaging. This staging is of crucial importance for the therapeutic strategy, taking into account that some stages could be still reversible. Several medical treatments have been suggested to interrupt the progression toward clinical CDI but the results are still discussed.
authors.affiliation: Department of Cardiothoracic and Respiratory Sciences, Second University of Naples, Via Leonardo Bianchi, Monaldi Hospital, 80131 Naples, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Bellastella
authors.forename: Antonio
authors.initials: A
authors.lastname: Bizzarro
authors.forename: Caterina
authors.initials: C
authors.lastname: Colella
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Bellastella
authors.forename: Antonio A
authors.initials: AA
authors.lastname: Sinisi
authors.forename: Annamaria
authors.initials: A
authors.lastname: De Bellis
mesh_terms: D001327:Autoimmune Diseases / Q000209:etiology / Q000276:immunology / Q000473:pathology*; D020790:Diabetes Insipidus, Neurogenic / Q000209:etiology / Q000276:immunology / Q000473:pathology*; D006801:Humans; D010902:Pituitary Gland / Q000473:pathology*