Montoliu J, Botey A, Revert L
Med Clin (Barc). 1980 Jan 10;74(1):28-30.
A 20-year-old patient was evaluated because of polydipsia and polyuria; by means of the dehydration test a partial defect in the secretion of antidiuretic hormone (ADH) was demonstrated, since the urinary osmolality after the administration of exogenous vasopressin was superior by 25 percent to the maximum spontaneous urinary osmolality reached after a period of fluid restriction. Nevertheless, there was also a component of psychogenic polydipsia because the daily basal fluid intake was superior to 15 liters, and in view of the fact that the urinary osmolality could reach 600 mOsm/kg, the endocrine defect cannot totally be responsible for the enormous volume of fluid intake. This is the first case in the world literature in which the association between potomania and deficiency in the secretion of ADH is reported. Since ADH is one of the factors which regulate the behaviour of various animal species it is possible that its deficiency may be directly responsible for the psychic disorder which led to the potomania. It is also possible that an anatomical hypothalamic lesion, too small to be demonstrated, might have a simultaneous effect on the centers regulating thirst and the neurons producing vasopressin.
一名20岁患者因烦渴和多尿接受评估;通过禁水试验,发现抗利尿激素(ADH)分泌存在部分缺陷,因为给予外源性血管加压素后的尿渗透压比限水一段时间后达到的最大自发尿渗透压高出25%。然而,也存在精神性烦渴成分,因为每日基础液体摄入量超过15升,而且鉴于尿渗透压可达到600 mOsm/kg,内分泌缺陷并不能完全解释大量的液体摄入。这是世界文献中首次报道低渗性多尿症与ADH分泌不足之间的关联。由于ADH是调节各种动物行为的因素之一,其缺乏可能直接导致了导致低渗性多尿症的精神障碍。也有可能存在一个太小而无法显示的下丘脑解剖病变,对调节口渴的中枢和产生血管加压素的神经元同时产生影响。