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Original Articles
- Clinical Study
- Factors Associated with Postoperative Diabetes Insipidus after Pituitary Surgery
- Antonio L. Faltado, Anna Angelica Macalalad-Josue, Ralph Jason S. Li, John Paul M. Quisumbing, Marc Gregory Y. Yu, Cecilia A. Jimeno
- Endocrinol Metab. 2017;32(4):426-433. Published online November 21, 2017
- DOI: https://doi.org/10.3803/EnM.2017.32.4.426
- 6,157 View
- 96 Download
- 13 Web of Science
- 14 Crossref
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Abstract
PDF
PubReader Background Determining risk factors for diabetes insipidus (DI) after pituitary surgery is important in improving patient care. Our objective is to determine the factors associated with DI after pituitary surgery.
Methods We reviewed records of patients who underwent pituitary surgery from 2011 to 2015 at Philippine General Hospital. Patients with preoperative DI were excluded. Multiple logistic regression analysis was performed and a predictive model was generated. The discrimination abilities of the predictive model and individual variables were assessed using the receiving operator characteristic curve.
Results A total of 230 patients were included. The rate of postoperative DI was 27.8%. Percent change in serum Na (odds ratio [OR], 1.39; 95% confidence interval [CI], 1.15 to 1.69); preoperative serum Na (OR, 1.19; 95% CI, 1.02 to 1.40); and performance of craniotomy (OR, 5.48; 95% CI, 1.60 to 18.80) remained significantly associated with an increased incidence of postoperative DI, while percent change in urine specific gravity (USG) (OR, 0.53; 95% CI, 0.33 to 0.87) and meningioma on histopathology (OR, 0.05; 95% CI, 0.04 to 0.70) were significantly associated with a decreased incidence. The predictive model generated has good diagnostic accuracy in predicting postoperative DI with an area under curve of 0.83.
Conclusion Greater percent change in serum Na, preoperative serum Na, and performance of craniotomy significantly increased the likelihood of postoperative DI while percent change in USG and meningioma on histopathology were significantly associated with a decreased incidence. The predictive model can be used to generate a scoring system in estimating the risk of postoperative DI.
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Citations
Citations to this article as recorded by
- Importance of Intraoperative Factors in Postoperative Arginine Vasopressin Deficiency After Pituitary Adenoma Surgery
Nasim Alidaei, Guive Sharifi, Zahra Davoudi
Endocrine Practice.2024; 30(3): 253. CrossRef - Incidence of post-operative diabetes insipidus and associated factors after pituitary surgery in two teaching hospitals, in Addis Ababa, Ethiopia: A prospective observational study
Abera Chanie, Abat Sahlu
Interdisciplinary Neurosurgery.2024; 37: 101978. CrossRef - Pituitary Adenoma in the Philippines: A Scoping Review on the Treatment Gaps, Challenges, and Current State of Care
Mykha Marie B. Tabuzo, Mary Angeline Luz U. Hernandez, Annabell E. Chua, Patricia D. Maningat, Harold Henrison C. Chiu, Roland Dominic G. Jamora
Medical Sciences.2024; 12(1): 16. CrossRef - In Reply to the Letter to the Editor Regarding “Risk Factors Related to Transient Diabetes Insipidus Development Following Transsphenoidal Pituitary Adenoma Resection: A Multicentric Study”
Marcos Ezequiel Yasuda, Daniela Renedo, Rodolfo Recalde, Roberto Zaninovich, Santiago Gonzalez Abbati, Andrés Cervio, Sebastian Giovannini, Juan Villalonga, Liezel Ulloque-Caamaño, Kesava Reddy, Mariano Socolovsky, Alvaro Campero
World Neurosurgery.2024; 185: 484. CrossRef - Letter to the Editor Regarding “Risk Factors Related to Transient Diabetes Insipidus Development Following Transsphenoidal Pituitary Adenoma Resection: A Multicentric Study”
Karlos Acurio, Fritz Fidel Váscones-Román, Fernando Canazas-Paredes, Aryan Wadhwa, Niels Pacheco-Barrios
World Neurosurgery.2024; 185: 483. CrossRef - Correlation of Pituitary Descent and Diabetes Insipidus After Transsphenoidal Pituitary Macroadenoma Resection
Josh Ma, Peter Gooderham, Ryojo Akagami, Serge Makarenko
Neurosurgery.2023; 92(6): 1269. CrossRef - Risk Factors Related to Transient Diabetes Insipidus Development Following Transsphenoidal Pituitary Adenoma Resection: A Multicentric Study
Marcos Ezequiel Yasuda, Daniela Renedo, Soledad Sosa, Karina Danilowicz, Rodolfo Recalde, Roberto Zaninovich, Santiago Gonzalez Abbati, Andrés Cervio, Sebastian Giovannini, Juan Villalonga, Liezel Ulloque-Caamaño, Kesava Reddy, Mariano Socolovsky, Alvaro
World Neurosurgery.2023; 175: e636. CrossRef - Change in cephalocaudal tumor cavity diameter after transsphenoidal surgery is a predictor of diabetes insipidus in pituitary adenoma
Kunzhe Lin, Kaichun Fan, Shuwen Mu, Shousen Wang
European Journal of Medical Research.2022;[Epub] CrossRef - Change in the pituitary stalk deviation angle after transsphenoidal surgery can predict the development of diabetes insipidus for pituitary adenomas
Liang Xue, Jianwu Wu, Jie Chen, Yongkai Yang
Endocrine Connections.2022;[Epub] CrossRef - Disorders of Salt and Water Balance After Pituitary Surgery
Emily K Brooks, Warrick J Inder
The Journal of Clinical Endocrinology & Metabolism.2022; 108(1): 198. CrossRef - Postoperative diabetes insipidus: how to define and grade this complication?
Friso de Vries, Daniel J. Lobatto, Marco J. T. Verstegen, Wouter R. van Furth, Alberto M. Pereira, Nienke R. Biermasz
Pituitary.2021; 24(2): 284. CrossRef - Diaphragma sellae sinking can predict the onset of hyponatremia after transsphenoidal surgery for pituitary adenomas
Kunzhe Lin, Jun Li, Lingling Lu, Shangming Zhang, Shuwen Mu, Zhijie Pei, Cheng Wang, Jingying Lin, Liang Xue, Liangfeng Wei, Lin Zhao, Shousen Wang
Journal of Endocrinological Investigation.2021; 44(11): 2511. CrossRef - Adrenocorticotropic Hormone-Secreting Pituitary Macroadenoma
Ujjwala Murkute
Indian Journal of Continuing Nursing Education.2021; 22(2): 137. CrossRef - Sodium Perturbations After Pituitary Surgery
Kevin C.J. Yuen, Adnan Ajmal, Ricardo Correa, Andrew S. Little
Neurosurgery Clinics of North America.2019; 30(4): 515. CrossRef
- Importance of Intraoperative Factors in Postoperative Arginine Vasopressin Deficiency After Pituitary Adenoma Surgery
- Clinical Study
- Comparison of Fixed versus Calculated Activity of Radioiodine for the Treatment of Graves Disease in Adults
- Abigail U. Canto, Paulette N. Dominguez, Cecilia A. Jimeno, Jerry M. Obaldo, Ruben V. Ogbac
- Endocrinol Metab. 2016;31(1):168-173. Published online March 16, 2016
- DOI: https://doi.org/10.3803/EnM.2016.31.1.168
- 5,086 View
- 56 Download
- 12 Web of Science
- 13 Crossref
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Abstract
PDFPubReader
Background Radioactive iodine as a treatment modality has been shown in several studies to be a safe and effective therapy for Graves disease. However, there is still no uniformity regarding optimal dosing method. The aim of this study is to compare the efficacy of calculated and fixed dosing of radioiodine for the treatment of Graves disease.
Methods A hundred twenty-two patients diagnosed with Graves disease were randomized to receive either fixed or calculated dose of radioiodine. Those randomized to fixed activity received either low fixed activity at 9.9 mCi for thyroid gland size <40 g or high fixed activity at 14.9 mCi for thyroid gland size 40 to 80 g, and those grouped to calculated activity received 160 µCi/g of thyroid tissue adjusted for 24 hours radioiodine uptake. Thyroid function tests (free thyroxine [T4] and thyroid stimulating hormone [TSH]) were monitored at 10, 16, and 24 weeks after radioactive iodine therapy. The primary outcome, treatment failure was defined as persistently elevated free T4 and low TSH.
Results Of the 122 patients randomized, 56 in the fixed dose group and 56 in the calculated dose group completed the follow-up. At the end of 6 months, the percentage of treatment failure was 37.50% in the calculated dose group versus 19.64% in the fixed dose group with a relative risk of 0.53 (95% confidence interval, 0.28 to 0.98) favoring the fixed dose group.
Conclusion Fixed dose radioiodine has a significantly lower incidence of persistent hyperthyroidism at 6 months post-radioactive therapy.
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Citations
Citations to this article as recorded by- The Presence of Anti-TPO Antibodies Increase the Likelihood of
Post-I131 Hypothyroidism
Felix Quataert, Bert Bravenboer, Marleen Keyaerts, Corina Emilia Andreescu
Hormone and Metabolic Research.2024; 56(02): 134. CrossRef - A retrospective study with long term follow-up of Graves' disease patients treated with low activities of 131Iodine
Regina NEUMANN, Robert THOMANN, Gerhard W. GOERRES
The Quarterly Journal of Nuclear Medicine and Molecular Imaging.2024;[Epub] CrossRef - Outcome and incidence of hypothyroidism in low-dose radioactive iodine treatment for hyperthyroidism
Ku-Hung Lin, Jiun-Chang Wu, Ming-Che Wu
Revista Española de Medicina Nuclear e Imagen Molecular (English Edition).2024; : 500056. CrossRef - Possibility analysis of thyroid imaging parameters for dose adjustment in 131I treatment of hyperthyroidism
Xiaonan ZHANG, Junhong LI, Hui ZHOU, Qiteng LU, Hailian WEI, Aifeng LI, Xinyu WEI, Zhixiao WEI
The Quarterly Journal of Nuclear Medicine and Molecular Imaging.2023;[Epub] CrossRef - Predictors of Hypothyroidism Following Empirical Dose Radioiodine in Toxic Thyroid Nodules: Real-Life Experience
Busra Kuyumcu Demir, Ersen Karakilic, Emre Sedar Saygili, Nilgun Araci, Semra Ozdemir
Endocrine Practice.2022; 28(8): 749. CrossRef - Changes in Radiosensitivity to Gamma-Rays of Lymphocytes from Hyperthyroid Patients Treated with I-131
Valentina Dini, Massimo Salvatori, Mauro Belli, Maria Elena Lago, Alessandra Nosdeo, Donatella Pia Dambra, Luisa Lo Conte, Ilaria Pecchia, Alessandro Giordano
International Journal of Molecular Sciences.2022; 23(17): 10156. CrossRef - Current controversies in the management of Graves’ hyperthyroidism
Niroshan Francis, Thanuya Francis, John H Lazarus, Onyebuchi E Okosieme
Expert Review of Endocrinology & Metabolism.2020; 15(3): 159. CrossRef - Effect of Different 131I Dose Strategies for Treatment of Hyperthyroidism on Graves’ Ophthalmopathy
Shahrara Ariamanesh, Narjess Ayati, Zahra Mazloum Khorasani, Zohreh Mousavi, Victoria Kiavash, Zahra Kiamanesh, Seyed Rasoul Zakavi
Clinical Nuclear Medicine.2020; 45(7): 514. CrossRef - The relationship between thyroid eye disease and radioiodine treatment
Sarameth Thou, Sobhan Vinjamuri
Nuclear Medicine Communications.2019; 40(3): 194. CrossRef - 99mTc-pertechnetate thyroid scintigraphy predicts clinical outcomes in personalized radioiodine treatment for Graves’ disease
Zhao Lina, Zhang Wenqi, Xin Yubo, Wen Qiang, Bail Lin, Guan Feng, Ji Bin
Revista Española de Medicina Nuclear e Imagen Molecular (English Edition).2018; 37(6): 349. CrossRef - Predicción de los resultados clínicos en el tratamiento personalizado con yodo radiactivo de la enfermedad de Graves, mediante gammagrafía tiroidea con 99mTc-pertecnetato
L. Zhao, W. Zhang, Y. Xin, Q. Wen, L. Bail, F. Guan, Ji Bin
Revista Española de Medicina Nuclear e Imagen Molecular.2018; 37(6): 349. CrossRef - Articles inEndocrinology and Metabolismin 2016
Won-Young Lee
Endocrinology and Metabolism.2017; 32(1): 62. CrossRef - Clinical outcomes 1 year after empiric 131I therapy for hyperthyroid disorders
Lavinia Vija Racaru, Charlotte Fontan, Mathilde Bauriaud-Mallet, Séverine Brillouet, Olivier Caselles, Slimane Zerdoud, Delphine Bastié, Delphine Vallot, Philippe Caron, Manuel Bardiès, Frederic Courbon
Nuclear Medicine Communications.2017; 38(9): 756. CrossRef
- The Presence of Anti-TPO Antibodies Increase the Likelihood of
Post-I131 Hypothyroidism
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