{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:02:38Z","timestamp":1756339358260,"version":"3.44.0"},"reference-count":17,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,10,14]]},"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:p>Adipsic arginine vasopressin deficiency (AAVP-D) is caused by hypothalamic dysfunction (HD) due to varied aetiologies, including craniopharyngiomas. Its management is extremely challenging because two of the three regulatory mechanisms (thirst, arginine vasopressin, and renal medullary tonicity) for maintaining plasma osmolality are impaired (<jats:italic>thirst, arginine vasopressin<\/jats:italic>). These individuals develop severe dehydration and hypernatraemia, necessitating multiple emergency visits despite the administration of arginine vasopressin analogue (desmopressin). Here, we describe a case with HD secondary to craniopharyngioma treatment manifesting as AAVP-D, short stature, central hypothyroidism, hypoadrenalism and probable hypogonadism. AAVP-D was managed by fixing the renal water losses (using desmopressin) and water intake in a predetermined range. The treatment monitoring was done using total body weight and weekly to fortnightly serum sodium. Using this approach, the serum sodium was maintained in the range of 140\u2013150\u2009mmol\/L, and there were no emergency visits for hypernatraemia or hyponatraemia (dysnatraemia) at 3\u2009months.<\/jats:p>","DOI":"10.1136\/bcr-2024-261497","type":"journal-article","created":{"date-parts":[[2024,10,30]],"date-time":"2024-10-30T11:23:59Z","timestamp":1730287439000},"page":"e261497","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Adipsic arginine vasopressin deficiency: challenges in managing the intricate interplay of adipsia with polyuria"],"prefix":"10.1136","volume":"17","author":[{"given":"Aayush","family":"Malik","sequence":"first","affiliation":[{"name":"Endocrinology and Metabolism, All India Institute of Medical Science, Bhopal, Madhya Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rekha","family":"Singh","sequence":"additional","affiliation":[{"name":"Endocrinology and Metabolism, All India Institute of Medical Science, Bhopal, Madhya Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alpesh","family":"Goyal","sequence":"additional","affiliation":[{"name":"Endocrinology and Metabolism, All India Institute of Medical Science, Bhopal, Madhya Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2400-8739","authenticated-orcid":false,"given":"Rahul","family":"Gupta","sequence":"additional","affiliation":[{"name":"Endocrinology and Metabolism, All India Institute of Medical Science, Bhopal, Madhya Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,10,30]]},"reference":[{"key":"2025082700134083000_17.10.e261497.1","first-page":"630","article-title":"Adipsic Diabetes Insipidus\u2014The Challenging Combination of Polyuria and Adipsia: A","volume":"10","author":"Dalan","year":"2019","journal-title":"Case Rep Rev Lit Front Endocrinol"},{"key":"2025082700134083000_17.10.e261497.2","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1210\/clinem\/dgz043","article-title":"Clinical Situation, Therapy, and Follow-Up of Adult Craniopharyngioma","volume":"105","author":"Mende","year":"2020","journal-title":"J Clin Endocrinol Metab"},{"key":"2025082700134083000_17.10.e261497.3","first-page":"3","article-title":"Pediatric craniopharyngiomas: classification and treatment according to the degree of hypothalamic involvement","volume":"106","author":"Puget","year":"2007","journal-title":"Journal of Neurosurgery: Pediatrics"},{"key":"2025082700134083000_17.10.e261497.4","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1038\/nature25488","article-title":"Hierarchical neural architecture underlying thirst regulation","volume":"555","author":"Augustine","year":"2018","journal-title":"Nature New Biol"},{"key":"2025082700134083000_17.10.e261497.5","doi-asserted-by":"publisher","DOI":"10.1152\/ajprenal.00485.2016"},{"key":"2025082700134083000_17.10.e261497.6","doi-asserted-by":"crossref","first-page":"A605","DOI":"10.1210\/jendso\/bvab048.1234","article-title":"Pulmonary Embolism in Adipsic DI: Can Desmopressin Be a Contributing Factor?","volume":"5","author":"Campos-Lopes","year":"2021","journal-title":"J Endocr Soc"},{"key":"2025082700134083000_17.10.e261497.7","doi-asserted-by":"publisher","DOI":"10.1007\/s11102-011-0294-3"},{"key":"2025082700134083000_17.10.e261497.8","unstructured":"Srivatsa A , Majzoub JA . Disorder of water homeostasis. In: Pediatric endocrinology. New York: Informa Healthcare, n.d.: 651\u201392."},{"key":"2025082700134083000_17.10.e261497.9","unstructured":"Lifshitz F , ed. Pediatric endocrinology. 5th edn. New York: Informa Healthcare, 2007."},{"key":"2025082700134083000_17.10.e261497.10","doi-asserted-by":"publisher","DOI":"10.1111\/apha.12487"},{"key":"2025082700134083000_17.10.e261497.11","doi-asserted-by":"crossref","DOI":"10.3390\/jcm12051714","article-title":"Adaptation of the Brain to Hyponatremia and Its Clinical Implications","volume":"12","author":"Gankam Kengne","year":"2023","journal-title":"J Clin Med"},{"key":"2025082700134083000_17.10.e261497.12","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1210\/js.2018-00406","article-title":"Daily Sodium Monitoring and Fluid Intake Protocol: Preventing Recurrent Hospitalization in Adipsic Diabetes Insipidus","volume":"3","author":"Pabich","year":"2019","journal-title":"J Endocr Soc"},{"key":"2025082700134083000_17.10.e261497.13","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1111\/j.1365-2265.1993.tb00990.x","article-title":"Pharmacokinetics of 1\u2010deamino\u20108\u2010 d \u2010arginine vasopressin after various routes of administration in healthy volunteers","volume":"38","author":"Fjellestad\u2010Paulsen","year":"1993","journal-title":"Clin Endocrinol (Oxf)"},{"key":"2025082700134083000_17.10.e261497.14","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1007\/s00431-013-2108-2","article-title":"Pharmacokinetics of desmopressin administered as tablet and oral lyophilisate formulation in children with monosymptomatic nocturnal enuresis","volume":"173","author":"De Bruyne","year":"2014","journal-title":"Eur J Pediatr"},{"key":"2025082700134083000_17.10.e261497.15","doi-asserted-by":"crossref","first-page":"172","DOI":"10.5414\/CPP44172","article-title":"Plasma pharmacokinetics of desmopressin following sublingual administration: an exploratory dose-escalation study in healthy male volunteers","volume":"44","author":"Steiner","year":"2006","journal-title":"CP"},{"key":"2025082700134083000_17.10.e261497.16","doi-asserted-by":"crossref","DOI":"10.12659\/AJCR.934193","article-title":"Adipsic Diabetes Insipidus in Children: A Case Report and Practical Guide","volume":"22","author":"AlShoomi","year":"2021","journal-title":"Am J Case Rep"},{"key":"2025082700134083000_17.10.e261497.17","doi-asserted-by":"crossref","first-page":"76","DOI":"10.4158\/EP15940.RA","article-title":"Adipsic Diabetes Insipidus: A Review","volume":"22","author":"Eisenberg","year":"2016","journal-title":"Endocr Pract"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-261497","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T07:13:51Z","timestamp":1756278831000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-261497"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10]]},"references-count":17,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2024,10,30]]},"published-print":{"date-parts":[[2024,10]]}},"alternative-id":["10.1136\/bcr-2024-261497"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-261497","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2024,10]]}}}