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Eur J Endocrinol. 2011 Sep;165(3):411-20. doi: 10.1530/EJE-11-0437. Epub 2011 Jul 12.

Posterior pituitary (PP) evaluation in patients with anterior pituitary defect associated with ectopic PP and septo-optic dysplasia.

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1
Department of Pediatrics Epidemiology and Biostatistics Section, Scientific Directorate Pediatric Neuroradiology, IRCCS G. Gaslini Institute, University of Genova, Largo Gerolamo Gaslini 5, 16147 Genova, Italy.

Abstract

OBJECTIVE:

Controversies exist about posterior pituitary (PP) function in subjects with ectopic PP (EPP) and with cerebral midline defects and/or their co-occurrence. We investigate water and electrolyte disturbances in patients at risk for PP dysfunction.

DESIGN:

The study was conducted in a single Pediatric Endocrinology Research Unit.

METHODS:

Forty-two subjects with childhood-onset GH deficiency were subdivided into five groups: normal magnetic resonance imaging (n=8, group 1); EPP (n=15, group 2); septo-optic dysplasia (SOD) with normal PP (n=4, group 3); EPP and SOD without (n=7, group 4), and with additional midline brain abnormalities (n=8, group 5). At a mean age of 16.0±1.1 years, they underwent a 120 min i.v. infusion with hypertonic 5% saline and evaluation of plasma osmolality (Posm), arginine vasopressin (AVP), thirst score (in groups 1 and 2), and urinary osmolality were performed.

RESULTS:

Mean Posm and AVP significantly increased from baseline scores (284.7±4.9 mosm/kg and 0.6±0.2 pmol/l) to 120 min after saline infusion (300.5±8.0 mosm/kg and 10.3±3.3 pmol/l, P<0.0001). Group 5 showed higher mean Posm and lower mean AVP at all time points (P<0.0001). Mean thirst score did not show a significantly different trend between the groups 1 and 2. Urine osmolality was above 750 mosm/kg in all but seven patients after osmotic challenge.

CONCLUSIONS:

Patients with midline brain abnormalities and EPP have defective osmoregulated AVP. Patients with EPP and congenital hypopituitarism have normal PP function.

PMID:
21750044
DOI:
10.1530/EJE-11-0437
[Indexed for MEDLINE]
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