Osmoregulation of Vasopressin Secretion in Patients with the Syndrome of Inappropriate Antidiuresis Associated with Central Nervous System Disorders.

• KAMOI KYUZI

  Department of Medicine, Nagaoka Red Cross Hospital

• TOYAMA MAKOTO

  Department of Neurosurgery, Nagaoka Red Cross Hospital

• TAKAGI MASATO

  Department of Medicine, Nagaoka Red Cross Hospital

• KOIZUMI TAKAYUKI

  Department of Neurosurgery, Nagaoka Red Cross Hospital

• NIISHIYAMA KEN-ICHI

  Department of Neurosurgery, Nagaoka Red Cross Hospital

• TAKAHASHI KINOE

  Department of Orthopedics, Nagaoka Red Cross Hospital

• SASAKI HIDEO

  Department of Medicine, Nagaoka Red Cross Hospital

• MUTO TERUKAZU

  Department of Surgery, Nagaoka Red Cross Hospital

抄録

To clarify the characteristics of vasopressin (AVP) secretion in patients with the syndrome of inappropriate antidiuresis (SIAD) related to central nervous system disorders, we examined the response of AVP secretion to osmotic stimulus by hypertonic saline infusion and analyzed the possible causative factors in six patients with SIAD associated with head trauma or cerebral infarction. Hyponatremia developed after head trauma in four patients and cerebral infarction in two patients. In all patients the clinical state and laboratory findings fulfilled the criteria for SIAD, which was supported by either nonsuppressible plasma AVP levels or effectiveness of treatments with water restriction, demeclocycline, nonpeptide V₂ AVP antagonist or diphenylhydantoin. Although patterns of plasma AVP response to the osmotic stimulus varied, plasma AVP concentrations neither increased nor decreased to undetectable levels with a rise in plasma osmolality. In one patient, plasma AVP levels responded to increasing plasma osmolality when plasma osmolality normalized; in which the threshold and the sensitivity of osmostat were normal. In two other patients, AVP secretion responded to plasma osmolality after the treatment. The changes in AVP secretion were not due to nonosmotic stimuli for AVP release. In conclusion, this study shows that patients with SIAD and central nervous system disorders may have persistent AVP secretion with a loss of hypotonic suppression such as found in patients with adrenal insufficiency or depletional hyponatremia in central nervous system disorders, indicating that careful evaluation is necessary to determine the relationship between persistent AVP secretion and the pathogenesis of hyponatremic disorders.

収録刊行物

• Endocrine Journal

  Endocrine Journal 46 (2), 269-277, 1999

  一般社団法人 日本内分泌学会

キーワード

• Hyponatremia
• Vasopressin
• Osmoregulation
• SIAD and Central Nervous System Disorders

詳細情報

• CRID: 1390001206298692480
• NII論文ID: 10005555718
• NII論文ID: 130003420859
• NII書誌ID: AA10901436
• DOI: 10.1507/endocrj.46.269
• COI: 1:STN:280:DyaK1MzoslOltQ%3D%3D
• ISSN: 13484540
• ISSN: 09188959
• ISSN: http://id.crossref.org/issn/09188959
• PubMed: 10460011
• Web Site: http://www.jstage.jst.go.jp/article/endocrj1993/46/2/46_2_269/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/1999224962
• 本文言語コード: en
• データソース種別:
  • JaLC
  • Crossref
  • PubMed
  • CiNii Articles
• 抄録ライセンスフラグ: 使用不可