title: Adipsic diabetes insipidus and venous thromboembolism (VTE): recommendations for addressing its hypercoagulability.
abstract: Adipsic diabetes insipidus (ADI) is a rare disorder. It can occur after transcranial surgery for craniopharyngeoma, suprasellar pituitary adenoma and anterior communicating artery aneurysm but also with head injury, toluene exposure and developmental disorders. It is often associated with significant hypothalamic dysfunction and complications like obesity, sleep apnea, thermoregulatory disorders, seizures and venous thromboembolism (VTE). Morbidity and mortality data have been reported as single case reports with only one large series suggesting increased risk for VTE in patients with ADI. Here we report a mini-series of four patients with ADI and VTE. Post-surgery immobilization, obesity, infection, with prolonged hospitalization, hemoconcentration and changes in coagulation which might be induced by inadequate hormone treatment in the postoperative period (high doses of glucocorticoids, sex steroids and DDAVP replacement) may all contribute to the pathogenesis of VTE. Thromboprophylactic treatment after pituitary surgery and during episodes of hypernatremia is therefore warranted.
authors: Clinic of Endocrinology, Medical Faculty, Belgrade University, Clinical Center of Serbia, Belgrade, Serbia.
authors: Dragana
authors: D
authors: Miljic
authors: Clinic of Hematology; Medical Faculty, Belgrade University, Clinical Center of Serbia, Belgrade, Serbia.
authors: Predrag
authors: P
authors: Miljic
authors: Clinic of Endocrinology, Medical Faculty, Belgrade University, Clinical Center of Serbia, Belgrade, Serbia.
authors: Mirjana
authors: M
authors: Doknic
authors: Clinic of Endocrinology, Medical Faculty, Belgrade University, Clinical Center of Serbia, Belgrade, Serbia.
authors: Sandra
authors: S
authors: Pekic
authors: Clinic of Endocrinology, Clinical Center of Serbia; Belgrade, Serbia.
authors: Marko
authors: M
authors: Stojanovic
authors: Clinic of Endocrinology, Medical Faculty, Belgrade University, Clinical Center of Serbia, Belgrade, Serbia.
authors: Milan
authors: M
authors: Petakov
authors: Clinic of Endocrinology, Medical Faculty, Belgrade University, Clinical Center of Serbia, Belgrade, Serbia.
authors: Vera
authors: V
authors: Popovic
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D001777:Blood Coagulation / Q000187:drug effects; D003919:Diabetes Insipidus / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D006801:Humans; D006955:Hypernatremia / Q000209:etiology; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D010902:Pituitary Gland / Q000473:pathology / Q000601:surgery*; D012307:Risk Factors; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D055815:Young Adult
chemical_list: D000925:Anticoagulants