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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):

Niki Karavitaki

, Shahzada K. Ahmed

, and John A.H. Wass

DOI:
10.1093/med/9780198746690.003.0245
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date: 25 February 2021

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 of dilute urine due to vasopressin deficient synthesis and/or release. The most common cause is lesions of the neurohypophysis or the hypothalamic median eminence damaging the magnocellular neurons. 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 is used for more severe cases. The syndrome of inappropriate antidiuresis is diagnosed when there is hyponatraemia with hypotonic plasma, inappropriate urine osmolality, and urinary sodium more than 20 mmol/litre, together with no evidence of volume overload or hypovolaemia, and normal renal, adrenal, and thyroid function.

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