Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C1332347 (ADH)
 2,230 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Although the syndrome of inappropriate ADH secretion (SIADH) has many causes, principally pulmonary, central nervous system or neoplastic disease, and drugs, patients may present with SIADH in whom the etiology is not readily evident. We measured serum ADH levels in such an individual in both the eunatremic and water-loaded states and found levels to be undetectable despite failure to dilute the urine. A small oat cell pulmonary carcinoma was ultimately diagnosed with lung tomograms and cytology. Following a partial response to water restriction, demeclocycline was effective in producing a water diuresis that restored the serum sodium concentration to normal. Patients with clinical SIADH but low serum ADH levels can harbor a malignant or benign process that, notwithstanding the low ADH levels, may still remain responsive to demeclocycline, suggesting either neoplastic production of a biologically-active, immunologically-inactive ADH-like peptide, or increased renal tubular sensitivity to ADH.
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PMID:Occult pulmonary malignancy in syndrome of inappropriate ADH secretion with normal ADH levels. 609 18

The role played by prostaglandins in the secretion of ADH and modulation of its action was investigated by testing the effects of prostaglandin synthesis inhibition in patients with SIADH of cerebral or pulmonary origin. Three patients with SIADH of central origin and 3 with SIADH of peripheral origin were subjected to 4 successive water-loading tests. In the first and fourth tests, the patients absorbed water 20 ml/kg bodyweight; in the second test they absorbed alcohol 2.5 ml/kg followed by water 17.5 ml/kg. The third test was preceded by a 3-day inhibition of prostaglandin synthesis with indomethacin 200 mg/day and aspirin 1.5 g/day. In patients with SIADH of peripheral origin the percent water-load excreted after 4 hours was low (less than 35%) with the 4 tests, whereas it reached 80% (p less than 0.001) with the third test (prostaglandin inhibition) in those with SIADH of central origin. Alcohol did not significantly correct the antidiuretic effect in any of the patients in both groups. It is concluded that prostaglandins reduce ADH secretion in central SIADH but do not modify antidiuresis in peripheral SIADH, since ectopic secretion probably does not depend on prostaglandins. The prostaglandin inhibition test therefore seems to be more helpful than the alcohol test to differentiate between central and peripheral SIADH. Further studies, however, are required to confirm these findings.
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PMID:[Inhibition of prostaglandins in the syndrome of inappropriate secretion of antidiuretic hormone (SIADH)]. 622

The ectopically produced polypeptide hormones ACTH, ADH, and calcitonin were investigated as tumor markers in patients with small-cell carcinoma of the lung (SCC). Plasma ADH concentrations were evaluated separately as well as in relation to concomitantly obtained plasma osmolality levels. No significant nor consistent changes of marker concentrations caused by lysis of tumor cells were found immediately after administration of cytotoxic drugs. After tumor regression, plasma ACTH and serum calcitonin concentrations and inappropriate ADH secretion (plasma ADH levels inappropriately high compared with plasma osmolality) became normal in most cases; however, progressive disease was not followed consistently by changes in plasma ACTH concentrations and occurrence of inappropriate ADH secretion. Contrary to this, among 12 patients with disease progression, serum calcitonin levels increased in ten patients and plasma ADH levels increased in 11 patients. In most cases, however, these changes were only moderate, and serum calcitonin concentrations were found to be increased after tumor regression in patients who had normal pretreatment levels. It is concluded that decisions on treatment of patients with SCC cannot exclusively be based on changes in the concentrations of the polypeptide hormones that might be of ectopic origin.
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PMID:ACTH, ADH, and calcitonin concentrations as markers of response and relapse in small-cell carcinoma of the lung. 625 49

The very rare occurrence of an ADH-producing small cell carcinoma of the lung in a 52 year old male patient with cranial diabetes insipidus since childhood is described. In this case diabetes insipidus disappeared concomitantly with development of lung cancer and re-appeared with shrinkage of the lung tumour by radiation therapy. Further progressive expansion of the primary and metastatic tumours induced the syndrome of inappropriate ADH secretion once again (SIADH). This deterioration in the clinical course was reflected in the plasma levels of ADH and neurophysins. The existence of vasopressin in the tumour tissue was also demonstrated by means of an immunohistochemical staining technique combined with anti-vasopressin serum.
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PMID:Spontaneous remission of cranial diabetes insipidus due to concomitant development of ADH-producing lung cancer--an autopsied case. 631 89

The effects of naturally occurring lysine and arginine vasopressins (LVP and AVP) were compared with those of 1-deamino-8-D-arginine-vasopressin (dDAVP) and 1-deamino-4-valine-D-arginine-vasopressin (dVDAVP). The changes of minute diuresis, urinary osmolarity and the duration of action were followed. dDAVP and dVDAVP in a single intravenous and intranasal dose decreased the diuresis more markedly (3.5-fold) and for a longer duration (3.3-fold) than did LVP in patients with central diabetes insipidus. The administration of dDAVP and dVDAVP in the form of sublingual tablets also proved to be effective, where dVDAVP acted more markedly and longer (16 hrs) than dDAVP (12 hrs) in a single dose of 30 micrograms. During one week of sublingual dDAVP administration, the accumulation of the drug was indicated by the gradual decrease of diuresis and the increase of urine osmolarity. The misuse of such highly active drugs may even result in iatrogenic inappropriate ADH syndrome (Schwartz-Bartter). The danger of this syndrome will be demonstrated in a case history. Some more recently synthesized vasopressin analogues with antagonistic action on the diuresis may have an important role in the therapy of Schwartz-Bartter syndrome. The authors present their results with one of these antagonists [1-(beta-mercapto-beta, beta-cyclopentamethylene-propionic acid), 2-O-ethyltyrosine, 4-valine] arginine vasopressin (d/CH2/5Tyr/Et/VAVP) both in Brattleboro and in R-Amsterdam rats. This analogue blocks the antidiuretic effect of both exogenous and endogenous vasopressin.
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PMID:[The effect of vasopressin analogs on water metabolism]. 666 81

The water and electrolyte status was studied in 26 children with acute asthma, 8 of whom required hospital admission. Patients were evaluated before therapy, during hospital management, and at least 10 days after symptoms had subsided. Laboratory evaluation included serum electrolytes, BUN, sOsmo, urinalysis, and uOsmo. Data were analyzed for the manifestations of SI-ADH. Mild serum hyposmolarity was noted initially in only two patients and during the hospital stay in one patient for a short time, but none of the patients fulfilled the criteria of SIADH. At the time of presentation at the emergency room, none of the 26 patients had clinical signs of dehydration, yet some degree of hypertonicity seemed to be present in most patients. This study shows that children with acute asthma are ordinarily not at high risk of SIADH and fluid therapy should be included in the management. Nevertheless, because such patients may be at risk of pulmonary edema, vigorous fluid administration should be discouraged, except to correct dehydration.
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PMID:Water and electrolyte status in children with acute asthma. 673 70

Sodium concentrations and osmolalities of simultaneously obtained venous blood and urine have been determined in a total of 61 children consisting of 18 children with malaria infection, 18 children with measles infection and 25 age- and sex-matched controls. The mean plasma osmolalities in the malaria and measles groups were significantly lower than in the control group (p less than 0.01). There was no difference between the measles and malaria groups either in their plasma osmolality (p greater than 0.20) or urine osmolality (p greater than 0.10). The u/p ratios for both osmolality and sodium concentrations where significantly higher for both the measles and malaria groups than for the matched controls. There was no difference in the u/p values between the malaria and measles groups (0.02 greater than p greater than 0.10). We conclude from these results that measles and malaria infected children demonstrate inappropriate secretion of ADH. Every child with these conditions should be carefully evaluated for the detection of evidence of SIADH. This is more important for children with measles who are frequently anorexic and may need intravenous infusion for maintenance of hydration.
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PMID:Syndrome of inappropriate antidiuretic hormone (SIADH) in measles and malaria infections. 702 95

A radioimmunoassay of ADH has been applied to the study of plasma ADH levels in various conditions. The validity of the assay has been evaluated by the usual quality control parameters of RIA and by the measure of plasma levels in 12 upright water deprived normal volunteers (mean 9.5 pg/ml, SEM +/- 1.5) in 8 resting and hydrated normal volunteers (1.3 +/- 0.4 pg/ml), in a case of diabetes insipidus (1.6 pg/ml), in 8 cases of SIADH Syndrome (range 13-77 pg/ml) and in 4 anesthetized dogs before (33.7 +/- 9.2 pg/ml) and after acute haemorrhage (66 +/- 9.5 pg/ml, p less than 0.02). The osmotoic challenge to ADH secretion has been studied in 8 patients with no overt endocrine pathology by salt perfusion and showed a significant rise (p less than 0.05) of plasma ADH from 6.3 +/- 3.1 pg/ml before, to 20.6 +/- 7.9 pg/ml during salt infusion corresponding to the significant (p less than 0.0001) rise of plasma osmolality from 273 +/- 2.8 to 288.2 +/- 1.1 m Osm/kg.
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PMID:Assessment of a plasma ADH radioimmunoassay in experimental and physiologic or pathologic conditions. 737 70

A 54-year-old woman underwent a left upper lobectomy for lung carcinoma after which hyponatremia developed within 5 days. Her serum concentration of ADH was within normal range disapproving the presence of SIADH frequently associated with lung carcinoma. An endocrinological examination showed panhypopituitarism. From her anamnesis it was seen that there was much perinatal bleeding and amenorrhea. She was diagnosed as suffering from Sheehan syndrome. She was treated with glucocorticoid and beneficial results were obtained. Her serum concentration of natrium returned to normal and she discharged on the 74th postoperative day. We present this paper because we had difficulty in determining that she had Sheehan syndrome, and think that a careful search for a diagnosis before operation is important for the management of the patient during the perioperative and postoperative period.
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PMID:[A case of postoperative hyponatremia caused by Sheehan syndrome associated with lung carcinoma]. 756 72

A 67-year-old man with SIADH complicated by slowly progressing autonomic failure was described. The patient noticed constipation at the age of 57. In the following years, he suffered from urinary incontinence, depletion of sweating, impotence, sleeplessness with snore, and dizziness while walking. Physical examination revealed a masked oily face with slight cerebellar disturbance. Abnormality of autonomic function tests was recognized and he was diagnosed as Shy-Drager syndrome with gradually progressing, diffuse autonomic failure accompanied by slight cerebellar ataxia and Parkinsonism. Both serum sodium level and plasma osmotic pressure were reduced, whereas daily sodium excretion was more than 100mEq and urinary osmolality was about 500mOsm/kgH2O. His renal function was intact, and the adrenocortical and thyroid hormone levels were normal, then criteria of SIADH was fulfilled. SIADH was thought to have occurred on the basis of Shy-Drager syndrome. Water load test showed failure of adequate water diuresis, but intravenous phenytoin administration following the water load test ameliorated the diuresis to normal. The relationship between plasma osmolality and the ADH response indicates that ADH was adequately secreted in response to the increase in plasma osmolality but not suppressed in response to the decrease in plasma osmolality below 280mOsm/kgH2O. These results suggest that ADH synthesis in the hypothalamus and its secretion from the pituitary gland were both intact. The response of ADH secretion to the orthostatic hypotension induced by head-up tilt was quite blunted, being compatible with Shy-Drager Syndrome. Sleep disturbance was studied by polysomnography and laryngoscopy, and was revealed to be based upon severe sleep apnea due to incomplete paralysis of the bilateral vocal cords. Sleep apnea due to vocal cord paralysis is sometimes found to be complicated in patients with multiple system atrophy (MSA) including Shy-Drager syndrome, and is known as Gerhardt syndrome. This is the first report on a case of Shy-Drager syndrome complicated with SIADH and bilateral vocal cord paralysis. In this case, SIADH is caused by impaired afferent pathways from baroreceptors to the hypothalamus, which transfer inhibitory stimuli on ADH secretion. It is suggested that Shy-Drager syndrome should be considered one of the causes of SIADH.
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PMID:[A case of Shy-Drager syndrome complicated with syndrome of inappropriate secretion of antidiuretic hormone (SIADH) and incomplete paralysis of bilateral vocal cords]. 795 87


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