Syndrome of inappropriate antidiuresis in the absence of arginine vasopressin

Philip A. Kern, Richard J. Robbins, Daniel Bichet, Tomas Berl, Joseph G. Verbalis

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

Abstract

The syndrome of inappropriate antidiuresis (SIAD) is usually associated with inappropriately elevated plasma arginine vasopressin (AVP) concentrations. We describe herein a patient with a macroprolactinoma who had symptomatic hyponatremia due to SIAD. Although the patient had excessive thirst, severe plasma hypoosmolality, and hyperosmolar urine, no immunoassayable AVP could be detected. During long term treatment with bromocriptine, there was gradual shrinkage of the prolactinoma coincident with improvement in the ability to excrete a water load and normalization of the thirst threshold. At this point, plasma immunoactive AVP was measurable during a hypertonic saline infusion for the first time. By high pressure liquid chromatographic analysis, this immunoactive substance coeluted with AVP. These studies suggest that the SIAD in this patient was due to the production of an antidiuretic substance distinct from AVP in association with his prolactinoma.

Original languageEnglish (US)
Pages (from-to)148-152
Number of pages5
JournalJournal of Clinical Endocrinology and Metabolism
Volume62
Issue number1
DOIs
StatePublished - Jan 1986

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical

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