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ISE Webinar: Diabetes Insipidus - From Differential Diagnosis to Post-operative DI
The differential diagnosis of Diabetes insipidus has long been based on the water deprivation test, indirectly measuring Arginine Vaspressin (AVP) activity by assessing urine concentration capacity. However, its diagnostic accuracy is limited and it is a cumbersome test for patients.
Copeptin derives from the same precursor hormone than Arginine Vasopressin (AVP), and can easily be measured with a sandwich immunoassay. This talk will highlight new copeptin-based tests in the differential diagnosis of Diabetes insipidus.

Post-operative diabetes insipidus (DI) is a common, although usually transient, complication of neurosurgical procedures performed in the sellar and suprasellar region. DI can also occur following closed head trauma due to trauma to the pituitary stalk with subsequent degeneration of the neurophypophyseal terminals in the posterior pituitary.

This session will help you:
1) Recognize the different etiologies of the polyuria polydipsia syndrome
2) Identify the limitations of the water deprivation test
3) Interpret copeptin upon hypertonic saline infusion
4) Understand non-osmotic stimuli of copeptin and their possible value in the differential diagnosis of Diabetes insipidus
5) Have a better understanding of the pathophysiology of post-operative and post-traumatic diabetes insipidus, including the triphasic response and adipsic diabetes insipidus.
6) Recognize patients at higher risk of post-operative DI.
7) Appreciate how an isolated second phase of the triphasic response can cause postoperative or post-traumatic hyponatremia without diabetes insipidus.
8) Identify the appropriate use of fluids and desmopressin in the postoperative and post-traumatic patient, and recognize how this differs based on the underlying pathophysiology.

*This activity is supported by an unrestricted educational grant from Thermo Fisher.

Apr 16, 2021 04:00 PM in Amsterdam

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Speakers

Dr Mirjam Christ-Crain
Prof, MD, PhD
Mirjam Christ-Crain is full Professor of Endocrinology, Diabetes and Metabolism at the University of Basel and the University Hospital of Basel, Switzerland. She studied medicine in Basel and Vienna and did her MD in the year 2000 and her habilitation in 2007 at the University of Basel and her PhD 2008 at the University of London. Her main research interest is on vasopressin-dependent disorders of fluid homeostasis, i.e. diabetes insipidus and hyponatremia. She authored and co-authored more than 200 publications including high-ranked publications in the New England Journal of Medicine , The Lancet and JAMA and received several honors and awards for her research.
Dr Joseph Verbalis
Professor of Medicine, Chief of Endocrinology and Metabolism, Georgetown University, Washington, DC USA
Joseph G. Verbalis, MD, graduated from Princeton University with an AB in chemistry in 1971, and received an MD from the University of Pittsburgh in 1975. Dr. Verbalis was a faculty member at the University of Pittsburgh from 1980 through 1995 where he rose to the position of tenured Professor of Medicine, and then relocated to Georgetown University in Washington, DC where he has served as the Chief of the Division of Endocrinology and Metabolism since 1995. Dr. Verbalis’ research has been continuously funded by the NIH for 25 years and has concentrated on mechanisms underlying adaptation to hyponatremia, renal escape from vasopressin, osmotic regulation of hypothalamic gene expression, sex differences in physiology and pathophysiology, exercise-associated hyponatremia, hyponatremia-induced osteoporosis, and clinical use of vasopressin receptor antagonists.
Dr Emanuel Christ (Moderator)
Prof, MD, PhD
Since 2017 Dr Emanuel Christ is Head of Interdisciplinary Endocrinology at the University Hospital of Basel (Switzerland) and since 2019 Deputy Head of the Center for Endocrine and neuroendocrine tumors (ENETS Center of Excellence, Basel). He is also the Secretary-Treasurer of the international Society of Endocrinology. Dr Christ is a Consultant in Endocrinology and Diabetology covering the whole spectrum of endocrinology, diabetology and metabolism, with a special interest in neuroendocrine tumours, pituitary adenoma and rare metabolic disorders.