ECE2017 Eposter Presentations: Pituitary and Neuroendocrinology Pituitary - Clinical (145 abstracts)
Autonomic impairment in idiopathic diabetes insipidus
Mattia Barbot 1 , Filippo Ceccato 1 , Marialuisa Zilio 1 , Nora Albiger 1 , Marco Boscaro 1 , Franca Bilora 2 & Carla Scaroni 1
1Endocrinology Unit, Department of Medicine, DIMED, Padova, Italy; 2Vascular Medicine Unit, Department of Cardiovascular Sciences, Padova, Italy.
Introduction: Since DI was reported to be associated to increase mortality, the aim of this study is to evaluate the presence of autonomic dysfunction (AD) in patients with DI.
Methods: We enrolled 12 patients (six females) with central idiopathic DI and 12 controls, matched for age, sex and common cardiovascular risk factors, who were evaluated using the tilt, lying-to-standing, hand grip, deep breath, Valsalva maneuver and Stroop tests.
Results: The tilt test showed a significant more pronounced decrease in both systolic (−20.7±18 vs −1.92±7 mmHg, P=0.0009) and diastolic blood pressure (−10.5±14.3 vs −1.5±5.5 mmHg, P=0.02) in patients than in controls. Furthermore three patients with DI had to suspend the test because of the onset of syncope. The lying-to-standing test indicated a marked reduction in blood pressure in patients with DI too (1.047±0.137 vs 1.533±0.144, P=0.0001). Similar results were find in Valsalva (ratio, 1.033±0.193 vs 1.431±0.109, P=0.00001) and deep breath tests (1.075±0.112 vs 1.33±0.083, P=0.00002).
Discussion: All the principal autonomic tests performed were concordant, indicating that patients with central DI have an impaired autonomic nervous system function despite normal hydroelectrolytic balance under desmopressin therapy. This impairment may reflect both a damage in the autonomic system and the absence of the vasoactive effect of AVP on vascular smooth muscle which acts as a rescue mechanism in case of rapid drop in blood pressure. Patients with central DI should be educated on how to prevent orthostatic hypotension.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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