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一只抗利尿激素渗透调节功能缺陷犬的低渗性高钠血症

Hypodipsic hypernatremia in a dog with defective osmoregulation of antidiuretic hormone.

作者信息

DiBartola S P, Johnson S E, Johnson G C, Robertson G L

机构信息

Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Ohio State University, Columbus 43210.

出版信息

J Am Vet Med Assoc. 1994 Mar 15;204(6):922-5.

PMID:8188513
Abstract

Hypernatremia was detected in a dog that was evaluated because of seizures. During hospitalization, the dog was fully conscious and remained hypernatremic when drinking voluntarily and when water was added to the food. Urine volume increased and urine osmolality decreased during an infusion of hypertonic saline (2.5% NaCl) solution, despite development of progressive hyperosmolality. There was no correlation between plasma antidiuretic hormone concentration and osmolality during the infusion study. The dog released antidiuretic hormone normally after nonosmotic stimulation (ie, apomorphine administration). These findings allowed a diagnosis of hypodipsic hypernatremia caused by destruction of hypothalamic osmoreceptors. At necropsy, there was hydrocephalus, atrophy of the septum pellucidum, and neuraxonal dystrophy of the cuneate nuclei. The underlying neurologic disease responsible for the CNS lesions could not be determined, but hydrocephalus may have led to pressure atrophy in the region of the hypothalamus that contains osmoreceptors.

摘要

一只因癫痫发作接受评估的犬被检测出高钠血症。住院期间,这只犬意识清醒,在自主饮水以及在食物中加水时仍处于高钠血症状态。在输注高渗盐水(2.5%氯化钠)溶液期间,尽管血浆渗透压逐渐升高,但尿量增加而尿渗透压降低。在输注研究期间,血浆抗利尿激素浓度与渗透压之间无相关性。这只犬在非渗透性刺激(即给予阿扑吗啡)后正常释放抗利尿激素。这些发现提示诊断为下丘脑渗透压感受器破坏所致的低渗性高钠血症。尸检时,发现有脑积水、透明隔萎缩以及楔束核神经轴突营养不良。导致中枢神经系统病变的潜在神经疾病无法确定,但脑积水可能导致了含有渗透压感受器的下丘脑区域的压迫性萎缩。

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