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.