Major P, Kuchel O, Boucher R, Nowaczynski W, Genest J
J Clin Endocrinol Metab. 1978 Jan;46(1):15-9. doi: 10.1210/jcem-46-1-15.
A female patient presenting clinically a severe hyponatremia was found to have a selective hypopituitarism with predominant ACTH and partial FSH, LH, and GH deficiency as well as a suppression of plasma renin activity and aldosterone. The adrenal cortex responded well in cortisol increase to ACTH infusion and in plasma aldosterone increase to angiotensin II infusion. The patient had pressor hyperreactivity to angiotensin II. The hyponatremia was caused by a negative sodium balance induced by excessive urinary loss which remained unaffected by mineralocorticoid treatment. Substitution doses of cortisol, however, corrected the disturbance with an increase in plasma renin activity and improvement in the sodium balance. The data are interpreted as indicating a direct or indirect regulatory (permissive?) effect of low doses of cortisol on plasma renin activity correcting the underlying disturbance--the secondary hyporeninism.
一名临床上表现为严重低钠血症的女性患者被发现患有选择性垂体功能减退，主要是促肾上腺皮质激素（ACTH）缺乏，部分促卵泡生成素（FSH）、促黄体生成素（LH）和生长激素（GH）缺乏，同时伴有血浆肾素活性和醛固酮的抑制。肾上腺皮质对ACTH输注引起的皮质醇增加以及血管紧张素II输注引起的血浆醛固酮增加反应良好。该患者对血管紧张素II有升压高反应性。低钠血症是由尿钠过度丢失导致的负钠平衡引起的，盐皮质激素治疗对此无影响。然而，替代剂量的皮质醇可通过增加血浆肾素活性和改善钠平衡来纠正这种紊乱。这些数据被解释为表明低剂量皮质醇对血浆肾素活性具有直接或间接的调节（允许？）作用，从而纠正潜在的紊乱——继发性低肾素血症。
