Abnormalities in the response of plasma arginine vasopressin during hypertonic saline infusion in patients with eating disorders.

We examined the response of plasma arginine vasopressin (pAVP) to intravenous 5% hypertonic saline in patients with anorexia nervosa (AN) and bulimia nervosa (BN). Patients did not differ from controls in their subjective response for the onset of thirst; however, only 5 patients (3 AN and 2 BN) showed pAVP levels that were within the normal range (0.5-11.0 pg/ml) for this test. With the exception of two eating disorder (ED) patients, all others showed some nonlinear irregularities in the pattern of their secretion of pAVP in response to the hypertonic saline infusion. Seven of the ED patients showed an irregular abnormally high pAVP secretion, and three patients showed abnormally low pAVP responses. Both of these pAVP secretion abnormalities occurred in underweight and weight-recovered AN patients, as well as in BN patients. The cause and pathophysiological consequences of these abnormalities remain unresolved.