特发性、持续性、不适当的抗利尿激素分泌伴高血压和口渴。

Idiopathic, sustained, inappropriate secretion of ADH with associated hypertension and thirst.

作者信息

Whitaker M D, McArthur R G, Corenblum B, Davidman M, Haslam R H

出版信息

Am J Med. 1979 Sep;67(3):511-5. doi: 10.1016/0002-9343(79)90802-7.

Abstract

A 15 year old girl presented with excessive thirst and hypertension (170/110 mm Hg). Biochemical investigations revealed serum sodium 118 meq/liter, serum osmolality 238 mosmol/liter, urine sodium 90 meq/liter, urine osmolality 700 mosmol/liter, persistenly elevated serum antidiuretic hormone (ADH) levels (5.8 to 11.9 pg/ml) and no obvious cause for the hypertension. The hypertension is, at least in part, volume-related, diminishing with fluid restriction. Features of gross water intoxication (e.g., confusion, coma) have not occurred. The etiology of the inappropriate secretion of ADH is not obvious but is not thought to be due to "resetting of osmoreceptors" as evidenced by failure to maximally dilute urine following a water load test and persistently elevated serum ADH levels. A similar patient described by Epstein and associates in 1962 is presently well with persistent features of inappropriate secretion of ADH.

摘要

一名15岁女孩出现烦渴和高血压（170/110 mmHg）。生化检查显示血清钠118 meq/升，血清渗透压238 mosmol/升，尿钠90 meq/升，尿渗透压700 mosmol/升，血清抗利尿激素（ADH）水平持续升高（5.8至11.9 pg/ml），且高血压无明显病因。高血压至少部分与血容量有关，限液后有所减轻。未出现严重水中毒的特征（如意识模糊、昏迷）。ADH分泌不当的病因不明显，但不认为是由于“渗透压感受器重置”，因为水负荷试验后未能最大程度稀释尿液以及血清ADH水平持续升高可证明这一点。1962年爱泼斯坦及其同事描述的一名类似患者目前状况良好，但仍有ADH分泌不当的持续特征。