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Cited by 67Electrolyte and hormonal disordersPituitary Gland Disorders and TreatmentsAdrenal Hormones and Disorders

A longitudinal study of vasopressin cell antibodies, posterior pituitary function, and magnetic resonance imaging evaluations in subclinical autoimmune central diabetes insipidus

De Bellis, A., Colao, A., Di Salle, F., Muccitelli, V. I., Iorio, S., Perrino, S., Pivonello, R., Coronella, C. +3 more·1999·The Journal of Clinical Endocrinology & Metabolism
DOI 10.1210/jcem.84.9.5945
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Abstract

Cytoplasmic autoantibodies to vasopressin-cells (AVPcAb) have been detected not only in patients with overt central diabetes insipidus (CDI), but also in patients with endocrine autoimmune diseases without CDI. This suggests that complete CDI can be preceded by a preclinical stage. Among 878 patients with endocrine autoimmune diseases without CDI, 9 patients found to be AVPcAb positive and 139 AVPcAb-negative controls were enrolled in this open prospective study. They were evaluated for AVPcAb and posterior pituitary function at least yearly for about 4 yr (range, 37–48 months); during this span, magnetic resonance imaging (MRI) of posterior pituitary and stalk was performed only in the AVPcAb-positive patients. Five of the 9 AVPcAb-positive patients had normal posterior pituitary function at study entry. They were AVPcAb positive throughout the follow-up period. At later stages of the study, 3 of them developed partial CDI, and 1 developed complete CDI. The remaining 4 patients showed impaired response to the water deprivation test at study entry and were diagnosed as having partial CDI. Two of them agreed to receive desmopressin replacement for 1 yr. After this treatment, the patients became negative for AVPcAb and displayed normal posterior pituitary function until the end of the follow-up. Conversely, the 2 untreated patients with partial CDI remained AVPcAb positive. One of them developed overt CDI. None of the controls became AVPcAb positive or developed CDI. The normal hyperintense MRI signal of the posterior pituitary, present at study entry, persisted subsequently in all 9 AVPcAb-positive patients, including those developing overt CDI, only disappearing in the late phase of complete CDI. In asymptomatic subjects, the monitoring of AVPcAb, but not MRI, seems to be useful to predict a progression toward partial/overt CDI. Early desmopressin therapy in patients with partial CDI could interrupt or delay the autoimmune damage and the progression toward clinically overt CDI.

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  • Clinicians are increasingly using newer liquid chromatography-mass spectrometric-based assays with suggested improved sensitivity and reduced interference, particularly for steroids such as estradiol and testosterone, and for thyroid and peptide hormones.

    “Clinicians are increasingly using newer liquid chromatography-mass spectrometric-based assays with suggested improved sensitivity and reduced interference.This is particularly true for steroids, namely E2, T (104,105), and thyroid and peptide hormones (78,106).”

    From Hormonal Replacement in Hypopituitarism in Adults: An Endocrine Society Clinical Practice Guideline (2016) · cites this paper as [104]

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Authors
De Bellis, A., Colao, A., Di Salle, F., Muccitelli, V. I., Iorio, S., Perrino, S., Pivonello, R., Coronella, C., Bizzarro, A., Lombardi, G., & Bellastella, A.
Affiliations
  • Institute of Endocrinology (A.D.B., V.I.H., S.I., S.P., A.Be.), Second University of Naples
  • the Department of Molecular and Clinical Endocrinology and Oncology (A.C., R.P., G.L.), 80131 Naples, Italy
  • the Institute of Radiological Sciences (F.D.S.), University Federico II, 80131 Naples, Italy
  • University of Campania "Luigi Vanvitelli" (IT)
Corresponding author
Bellastella, A.
ORCID
Venue
The Journal of Clinical Endocrinology & Metabolism
Publisher
The Endocrine Society
Published
1999-09-01
Volume
84
Issue
9
Pages
3047-3051
ISSN
  • 0021-972X (ISSN-L)
  • 1945-7197
DOI
10.1210/jcem.84.9.5945
OpenAlex
W2167967006
Semantic Scholar
65cd958510cbb8b135a13174a6000d11a775edcf
Cited by
67
References
22
Citations by year
2026: 1 · 2023: 3 · 2022: 6 · 2021: 2 · 2020: 3 · 2019: 2 · 2017: 2 · 2016: 4 · 2015: 2 · 2014: 2 · 2013: 4 · 2012: 5
FWCI
2.24
Type
journal article
Language
en
Open access
closed
Locations
  • The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
  • PubMed (publishedVersion)
  • Archivio Istituzionale della Ricerca - Università degli Studi della Campania "Luigi Vanvitelli" (submittedVersion)
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Electrolyte and hormonal disorders
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
Keywords
central diabetes insipidus, water deprivation test, autoimmune endocrine disease, disease progression, longitudinal follow-up
MeSH terms
Adolescent, Adult, Autoantibodies, Autoimmune Diseases, Deamino Arginine Vasopressin, Diabetes Insipidus, Female, Humans, Longitudinal Studies, Magnetic Resonance Imaging, Male, Pituitary Gland, Posterior, Prospective Studies, Vasopressins, Water Deprivation

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