Late recovery from chronic arginine vasopressin deficiency: a multicenter retrospective case-control study.

Context: Arginine vasopressin deficiency (AVP-D), caused by hypothalamic/pituitary damage from tumor or surgery, can be transient or chronic. Chronic AVP-D is thought to be permanent though emergent research indicates the possibility of late recovery. Little is known about clinical characteristics that predict late recovery from chronic AVP-D. Objective: Describe characteristics associated with late recovery from chronic AVP-D. Design: Multicenter, retrospective case-control study of AVP-D Recovered (n = 18) vs AVP-D Non-recovered (n = 36; matched for sex and disease duration). Main outcome measures: Clinical characteristics assessed at hypothalamic/pituitary disease diagnosis, AVP-D diagnosis, AVP-D recovery, and most recent clinical evaluation. We also present characteristics of three pediatric cases with AVP-D recovery. Results: At diagnosis of hypothalamic/pituitary disease, AVP-D Recovered, compared to AVP-D Non-recovered, were older (45 ± 19 vs 33 ± 13 years, Conclusion: Our study supports the notion that chronic AVP-D may not be permanent across the lifespan. Continued requirement for desmopressin, particularly in those with a history of functioning pituitary tumors, low doses of desmopressin, and without concurrent hypothyroidism or adrenal insufficiency at diagnosis, should be regularly reassessed.