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Query: UNIPROT:P01185 (
vasopressin
)
23,126
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
A 6-week-old girl with fever,
hypernatraemia
, dehydration, and polyuria failed to concentrate urine in response to exogenous
vasopressin
administration. There was no family history of nephrogenic diabetes insipidus. When she was 15 months old, the infusion of
vasopressin
did not produce an increase in urinary cyclic-AMP.
...
PMID:Congenital nephrogenic diabetes insipidus in a baby girl. 21 90
In a prospective study of abnormalities of plasma sodium concentration carried out over one year 20 patients were identified who had a concentration exceeding 154 mmol(mEq)/1. Of these, eight patients had diabetes mellitus, eight had primary intracranial disorder, and four had become dehydrated. Five of the eight diabetics presented with hyperosmolar, non-ketotic precoma, and in all eight
hypernatraemia
developed despite treatment with hypotonic (0.45%) saline. There was a good correlation (r = -0.93) between the rates of change of plasma sodium and blood glucose concentrations, and thus a rise in plasma sodium concentration appeared to be a consequence of the treatment. In the early phase of treatment urinary sodium loss was extremely low despite a brisk diuresis, the infused sodium then predisposing the patients to
hypernatraemia
. All of the eight patients with intracranial disorders showed evidence of abnormal production of the
antidiuretic hormone
, six having frank diabetes insipidus. Severe
hypernatraemia
in this group was associated with a high mortality, fluid balance being difficult to maintain. Two of the four patients who had become dehydrated had had a recent gastrointestinal haemorrhage. In these patients infusion of 0.9% saline contributed to the
hypernatraemia
since urinary sodium loss was low. Severe
hypernatraemia
in adults is uncommon, but in established cases plasma and urinary biochemical indices should be measured frequently. Monitoring of the central venous pressure is usually necessary, and patients are best managed in an intensive care unit.
...
PMID:Severe hypernatraemia in adults. 44 98
A 49-year-old man was submitted to neurosurgery for a cranio-pharyngioma. The lesion, which appeared to involve the antero-inferior wall of the third ventricle, caused lack of appropriate
antidiuretic hormone
(
ADH
) release in response to
hypernatraemia
and plasma hyperosmolality. The probable mechanism of this hypothalamic syndrome is suggested.
...
PMID:Neurogenic hypernatraemia: case report. 45 65
Sodium and water retention is constant in decompensated cirrhosis with ascites and edema.
Sodium retention
is due to several factors. Renal hemodynamic disturbances appear first: decrease in glomerular filtration and renal plasmatic perfusion, redistribution of renal perfusion to the juxtamedullar area where the longer nephrons reabsorb more sodium. Metabolic disorders of estrogens, natriuretic hormonal factor, prostaglandins and the kallikrein-kinin system contribute to greater sodium retention. Water retention is secondary to greater sodium reabsorption and to hyperactivity of the
antidiuretic hormone
. Sodium and water retention, associated with portal hypertension, with reduced oncotic pressure and with dynamic lymphatic insufficiency, is responsible for the production of ascites. The latter results in a decrease in the effective plasmatic volume, with non-suppression of the renin-angiotensin system, increased aldosterone production and additional sodium retention.
...
PMID:[The physiopathology of ascites]. 46 62
Two patients ( 1 7/12-year-old and 1 11/12-year-old girls) with chronic
hypernatremia
were studied. Neuroradiological findings and mildine facial defects showed characteristic features of holoprosencephaly. Water deprivation tests showed clear evidence of
antidiuretic hormone
(
ADH
) secretion. The responses to hypertonic saline infusion and acute water loading were abnormal. In one case, the impaired osmotic regulation of
ADH
secretion was demonstrated by measuring urinary
ADH
by a radioimmunoassay. In this case, the volume regulation of
ADH
secretion seemed to be also incomplete since chronic water loading for a period of six days induced water retension.
...
PMID:Chronic hypernatremia associated with holoprosencephaly. 48 1
Eighty-eight patients with craniocerebral trauma were studied prospectively to assess the effects of the injury on sodium and water balance. Abnormalities of serum sodium and osmolality occurred in 11 of the 76 patients who were on the study more than 24 hours, and the incidence of these abnormalities was directly related to the severity of the craniocerebral injury. Hyponatremic hypo-osmolar states were as frequent as were
hypernatremia
and serum hyperosmolality. The major cause of the hyponatremia was inappropriate
antidiuretic hormone
secretion;
hypernatremia
was due to dehydration and occurred predominantly in comatose patients with increased insensible fluid losses associated with pyrexia. We recommend that the initial fluid intake after craniocerebral trauma be kept between 1500 and 1800 ml/24 hours and that further fluid management be dictated by repeated serum electrolyte determinations. The electrolyte balance should be monitored continuously after a significant head injury for up to 2 weeks, because hyponatremic states sometimes develop more than 1 week after injury. The serum alcohol was measured on admission, and the level of serum alcohol correlated well with the serum osmolality on admission; thus, the degree of elevation of serum osmolality was a very good guide to the serum alcohol level. However, there was no statistically significant correlation between alcohol intoxication or chronic alcoholism and the late development of serum sodium and osmolality disturbances.
...
PMID:Metabolic disturbances after head injury: abnormalities of sodium and water balance with special reference to the effects of alcohol intoxication. 68 1
Described is a patient who presented with
hypernatremia
in the absence of dehydration. Further investigation revealed a tumor in the hypothalamic area, and evidence of anterior pituitary hypofunction. Water loading did not correct
hypernatremia
, and the results of the water-loading test suggested that
hypernatremia
had resulted from an elevated "osmotic set point" for the release of
antidiuretic hormone
, ie, "essential
hypernatremia
."
...
PMID:Essential hypernatremia. 68 42
Two patients with hypodipsia and
hypernatremia
are described. The first patient, whose hypodipsia was of unknown cause, developed
hypernatremia
unless large volumes of fluid were urged upon him; upon treatment with chlorpropamide normal serum sodium levels were achieved with spontaneous fluid intake. The second patient had hypodipsia and diabetes insipidus resulting from a craniopharyngioma. Treatment with
vasopressin
and a prescribed daily water intake resulted in frequent hyper- and hyponatremia, but treatment with chlorpropramide yielded serum sodium values which were more often normal and less variable. In neither patient could the improved water regulation be attributed to an effect of chlorpropamide on renal water excretion. Possible mechanisms for the effect of chlorpropamide on thirst are discussed.
...
PMID:Successful treatment of hypernatremic thirst deficiency with chlorpropamide. 69 8
A patient with the syndrome of chronic
hypernatremia
(serum Na+: mean = 154, range 139-184 mEq/l, n = 30) and hypodipsia due to a hypothalamic injury was studied to evaluate osmolar and baroreceptor control of arginine vasopressin (AVP) secretion. Resting plasma AVP levels measured by radioimmunoassay were inappropriately low for the degree of plasma hyperosmolality: range = less than 0.5-2.1 pg/ml, n = 10, with corresponding levels of plasma osmolality (P osM) greater than 300 m osmol/kg, suggesting either direct damage to the AVP synthesis and storage area or impaired afferent osmoreceptor function. Direct pituitary damage seemed unlikely, since anterior pituitary function was normal by standard testing. The existence of adequate
neurohypophyseal
stores of AVP was demonstrated by baroreceptor stimulation with the hypotensive agent trimethaphan (Arfonad): plasma AVP rising to 50.0 pg/ml during transient hypotension (BP = 70/0). Osmoreceptor function was evaluated during acute water loading followed by hypertonic saline infusion. During hypertonic saline infusion plasma AVP levels correlated with P osM (R = .87, P less than .01, n = 8), suggesting some residual osmotic regulation of AVP release. The osmotic threshold for AVP release (the x-axis intercept of the plasma AVP-P osM regression line) was not higher than normal. However, the AVP levels throughout this study remained markedly subnormal for the degree of plasma hyperosmolality (maximum plasma AVP = 1.9 PG/ML when P os M = 327 M OSMOL/KG). Since a substantial amount of AVP was released with baroreceptor stimulation, the inadequate rise in plasma AVP level with hyperosmolality indicates that afferent input from the osmoreceptor/thirst area of the hypothalamus is selectively impaired in this patient. These findings directly demonstrate a dissociation of osmoreceptor function from the AVP secretory apparatus in man.
...
PMID:Selective osmoreceptor dysfunction in the syndrome of chronic hypernatremia. 84 75
Acute and chronic effects on the fluid balance of radio-frequency forebrain lesions were studied in the goat. Medial lesions which involved practically the entire anterior wall of the third cerebral ventricle cause persistent loss of thirst and lack of significant
antidiuretic hormone
(
ADH
) release in response to
hypernatraemia
and plasma hyperosmolality. As acute response to such lesions an uncompensated, temporary water diuresis was seen, which rapidly caused pronounced
hypernatraemia
and hypovolaemia. Lesions extending laterally to encroach upon the supraoptic nuclei resulted in persistent signs of weak, inappropriate ADH secretion (=impaired water diuresis, renal salt wasting, and pronounced hyponatraemia during hydration). Forebrain damage, mainly restricted to the septal region, caused hyperdipsia. In some goats, obvious post-lesioning increase in salt appetite was observed which could not be coreelated to the extent of their forebrain damage. The results are discussed in relation to hypothalamic syndromes in man and previous studies on central control of fluid balance in the goat.
...
PMID:Perturbations in fluid balance induced by medially placed forebrain lesions. 118 46
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