Copeptin in the Diagnosis of Post-operative Insipidus Diabetes After Pituitary Surgery
Copeptin in the Diagnosis of Post-operative Insipidus Diabetes After Pituitary Surgery
Endoscopic trans-sphenoidal pituitary endoscopic surgery is one of the main axes of
 management of tumours of the sellar region.

 Central diabetes insipidus is a frequent complication of endoscopic trans-sphenoidal
 pituitary endoscopic surgery, with a prevalence of up to 30% of cases. It is the consequence
 of insufficient secretion of the anti-diuretic hormone arginine vasopressin (AVP) by the
 posterior pituitary (Melmed et al, 2017).

 In the absence of specific treatment, diabetes insipidus can lead to severe ionic and osmotic
 disorders, mainly acute dehydration with the risk of severe consequences particularly
 neurological.

 Monitoring for the appearance of diabetes insipidus is therefore necessary from the immediate
 post-operative period.

 To date, diabetes insipidus is initially suspected before the appearance of major polyuria.
 Several biological assays (urinary density, natraemia, urinary osmolarity and plasma) can
 help to confirm the diagnosis, but the sensitivity and specificity of these biomarkers
 remains quite low for this indication.

 The determination of MVA is difficult because this hormone is unstable ex vivo. To date, its
 use in current practice remains complicated.

 MVA and copeptin are derived from the same precursor and are therefore co-secreted by the
 pituitary gland in equimolar proportions.

 Copeptin has a relatively short in vivo half-life of about 25 minutes, as does MVA, but is
 more stable in vitro when blood has been drawn.

 Its use in the early diagnosis of diabetes insipidus after pituitary surgery could therefore
 be of interest.
Objective is to study the interest of copeptin dosage as an early predictive marker for the
 diagnosis of post-operatice diabetes insipidus in trans-sphenoidal endoscopic pituitary
 surgery.
inclusion criteria : adult patient patient undergoing pituitary surgery for tumour of the
 sellar region patient consenting to participate to the study patient enrolled in the
 national healthcare insurance program

 exclusion criteria : Patient with preoperative diabetes insipidus. Patient undergoing
 pituitary surgery for suspicion of craniopharyngioma Patient undergoing pituitary surgery
 for pituitary metastases Patient under 18 years