Herein we will describe a case of chronic hypernatremic-hyperosmolar syndrome with cerebral localization of systemic sarcoidosis. Several determinations of plasma arginine vasopressin (p-AVP) at various plasma sodium levels were carried out in this patient. During the study p-AVP values varied between 2.6 and 9.5 pg/ml. A high percentage of them was related to plasma osmolality, pointing out that p-AVP secretion was osmotically mediated. This behavior is in contrast with the tendency of hypernatremic patients previously reported in the literature, in whom p-AVP values were inappropriately low for the corresponding degree of plasma osmolality, suggesting that vasopressin secretion was not influenced by osmotic stimulation. Furthermore, our case, unlike those previously described, showed high values of urinary osmolality. In conclusion, our patient represents, in essence, the ‘middle’ of the spectrum of the hypodipsic-hypernatremic syndrome, because she is to be inserted between the majority of patients who have little or no osmotically mediated AVP release and the case of a child, recently described, who had completely normal AVP secretion.

Keywords:
Chronic hypernatremia, Hypo-adipsia, Plasma arginine vasopressin, Plasma hyperosmolality
This content is only available via PDF.
© 1990 S. Karger AG, Basel
1990
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.