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Disorders of the posterior pituitary gland 

Disorders of the posterior pituitary gland

Chapter:
Disorders of the posterior pituitary gland
Author(s):

Aparna Pal

, Niki Karavitaki

, and John A. H. Wass

DOI:
10.1093/med/9780199204854.003.1303

August 28, 2014: This chapter has been re-evaluated and remains up-to-date. No changes have been necessary.

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date: 18 August 2017

The posterior pituitary produces arginine vasopressin, which has a key role in fluid homeostasis, and oxytocin, which stimulates uterine contraction during birth and ejection of milk during lactation.

Cranial diabetes insipidus is the passage of large volumes (>3 litres/24 h) of dilute urine (osmolality<300 mOsm/kg) due to vasopressin deficiency, and most commonly occurs as a consequence of trauma or tumour affecting the posterior pituitary. Diagnosed by a water deprivation test revealing urine osmolality less than 300 mOsml/kg with concurrent plasma osmolality more than 290 mOsml/kg after dehydration, with urine osmolality rising to more than 750 mOsml/kg after desmopressin. MRI of the neurohypophysis is required to delineate the cause. Mild polyuria can be managed simply by ensuring adequate fluid intake; treatment with the long-acting vasopressin analogue, desmopressin (desamino, D-8 arginine vasopressin; DDAVP), is used for more severe cases....

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