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脑炎后的口渴、渗透压感受器重置及水中毒。

Thirst, resetting of the osmostat, and water intoxication following encephalitis.

作者信息

Howe J G, Penney M D, Currie S, Morgan D

出版信息

Ann Neurol. 1983 Feb;13(2):201-4. doi: 10.1002/ana.410130217.

DOI:10.1002/ana.410130217
PMID:6830180
Abstract

A young man developed pathological thirst and hyperdipsia, hyperphagia, disordered temperature regulation, a lowered threshold for aggressive behavior, apathy, impaired memory, and seizures following encephalitis. He had marked hyponatremia. Bouts of water drinking produced water intoxication and precipitated status epilepticus. Studies of water handling with measurements of plasma osmolality and arginine vasopressin (AVP) revealed a very low thirst threshold (below 242 mOsm/kg) with resetting of the osmostat to a new level (255 mOsm/kg) but normal control of plasma osmolality at that level with adequate AVP release.

摘要

一名年轻男子在患脑炎后出现病理性口渴、饮水过多、食欲亢进、体温调节紊乱、攻击行为阈值降低、冷漠、记忆力减退和癫痫发作。他有明显的低钠血症。饮水发作导致水中毒并引发癫痫持续状态。通过测量血浆渗透压和精氨酸加压素(AVP)来研究水代谢,结果显示其口渴阈值极低(低于242毫渗摩尔/千克),渗透压调定点重置到一个新水平(255毫渗摩尔/千克),但在该水平下血浆渗透压通过足够的AVP释放得到正常调节。

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引用本文的文献

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Chronic Hyponatremia: The Role of Reset Osmostat in Patients with Suspected SIAD.慢性低钠血症:渗透压调定点重设在疑似抗利尿激素分泌异常综合征患者中的作用
J Clin Med. 2024 Jun 17;13(12):3538. doi: 10.3390/jcm13123538.
2
Intractable hyponatremia complicated by a reset osmostat: a case report.顽固性低钠血症伴渗透压调节重置:病例报告。
J Med Case Rep. 2023 Jan 14;17(1):13. doi: 10.1186/s13256-022-03732-w.
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Clinical characteristics and outcomes of hyponatraemia associated with oral water intake in adults: a systematic review.成人口服水相关性低钠血症的临床特征和结局:系统评价。
BMJ Open. 2021 Dec 9;11(12):e046539. doi: 10.1136/bmjopen-2020-046539.
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Management Challenges in a Child with Chronic Hyponatremia: Use of V2 Receptor Antagonist.慢性低钠血症患儿的管理挑战:V2受体拮抗剂的应用
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