García Rull S, Romero Candeira S, del Castillo Alvarez S, Lago Viguera J, Sueiro Bendito A
Med Clin (Barc). 1981 Mar 10;76(5):226-9.
A case of pleuropulmonary infection without a demonstrable causal agent associated to inappropriate secretion of antidiuretic hormone is reported. Although antidiuretic hormone levels were not measured, unequivocal indirect proof of elevated levels was present as evidenced by characteristic serum and urinary electrolyte abnormalities, other possible causes having been carefully ruled out. The hyposmolar clinical picture was refractory to conservative measures, and it was corrected only when a loculated empyema was surgically drained by way of thoracotomy. The literature on inappropriate secretion of antidiuretic hormone related to pleuropulmonary pathology is briefly reviewed. Particular emphasis is made on the pleural encapsulation in the present case as the factor responsible for perpetuation of pulmonary infection and origin of the hormonal disturbance.
报告了一例胸膜肺部感染病例，该病例未发现可证实的致病因子，且与抗利尿激素分泌不当有关。尽管未测定抗利尿激素水平，但血清和尿液电解质特征性异常明确证明了抗利尿激素水平升高，其他可能原因已被仔细排除。低渗血症的临床表现对保守治疗无效，仅在通过开胸手术引流局限性脓胸后才得以纠正。本文简要回顾了与胸膜肺部病理相关的抗利尿激素分泌不当的文献。特别强调了本例中的胸膜包裹是导致肺部感染持续存在和激素紊乱的原因。
