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Increased oxytocin release precedes hyponatremia after pituitary surgery

Authors
  • Constanthin, Paul Eugène1, 2
  • Isidor, Nathalie3
  • de Seigneux, Sophie1
  • Momjian, Shahan1, 2
  • 1 Hôpitaux Universitaires de Genève (HUG),
  • 2 Université de Genève (UNIGE),
  • 3 Clinical Research Center, University of Geneva, Hôpitaux Universitaires de Genève (HUG),
Type
Published Article
Journal
Pituitary
Publisher
Springer-Verlag
Publication Date
Jan 28, 2021
Volume
24
Issue
3
Pages
420–428
Identifiers
DOI: 10.1007/s11102-020-01121-4
PMID: 33506439
PMCID: PMC8119398
Source
PubMed Central
Keywords
Disciplines
  • Article
License
Unknown

Abstract

Purpose The syndrome of inappropriate secretion of antidiuretic hormone (SIADH) is a well-known complication of transsphenoidal pituitary surgery, related to inappropriate secretion of arginine vasopressin (AVP). Its diagnosis is based on hyponatremia, with a peak of occurrence around day 7 after surgery and, to date, no early marker has been reported. In particular, copeptin levels are not predictive of hyponatremia in this case. Oxytocin (OXT) is secreted into the peripheral blood by axon terminals adjacent to those of AVP neurons in the posterior pituitary. Besides its role in childbirth and lactation, recent evidences suggested a role for OXT in sodium balance. The contribution of this hormone in the dysnatremias observed after pituitary surgery has however never been investigated. Methods We analyzed the urinary output of OXT in patients subjected to transsphenoidal pituitary surgery. Results While OXT excretion remained stable in patients who presented a normonatremic postoperative course, patients who were later diagnosed with SIADH-related hyponatremia presented with a significantly increased urinary secretion of OXT 4 days after surgery. Conclusion Taken together, these results show for the first time that urinary OXT output remains normally stable after transsphenoidal pituitary surgery. OXT excretion however becomes abnormally high on or around 4 days after surgery in patients later developing hyponatremia, suggesting that this abnormal dynamics of OXT secretion might serve as an early marker for transsphenoidal surgery-related hyponatremia attributed to SIADH. Supplementary Information The online version contains supplementary material available at 10.1007/s11102-020-01121-4.

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