Secondary arginine vasopressin deficiency Arginine vasopressin deficiency may also be secondary (acquired), caused by various lesions, including hypophysectomy, cranial injuries (particularly basal skull fractures), suprasellar and intrasellar tumors (primary or metastatic), Langerhans cell histiocytosis, lymphocytic hypophysitis, granulomas (sarcoidosis or tuberculosis), vascular lesions (aneurysm, thrombosis), and infections (encephalitis, meningitis).