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Renal Sodium Loss and Bronchogenic Carcinoma: Associated Autonomic Neuropathy

Renal Sodium Loss and Bronchogenic Carcinoma: Associated Autonomic Neuropathy Abstract The association of renal loss of sodium with diseases of the lungs has been reported for some years. Winkler and Crankshaw,1 in 1938, called attention to 15 cases of pulmonary tuberculosis in which low-serum chloride levels were associated with increased urinary losses of chloride. From their data they inferred that serum sodium levels were depressed too, and that urinary losses of sodium were excessive. They reported also a similar condition in a patient having carcinoma of the lung with a complicating mycotic infection. Since then, further attention has been drawn to the association of hyponatremia and pulmonary tuberculosis.2 In 1957 Schwartz and associates3 reported 2 cases of bronchogenic carcinoma in which hyponatremia developed because of an unexplained failure of renal sodium conservation. From their studies they concluded that the renal sodium loss was due to continued inappropriate secretion of antidiuretic hormone (ADH). In 1959 Roberts4 reported References 1. Urinary retention in the absence of demonstrable obstruction must be assumed to have a neurogenic basis. Parasympathetic innervation is thought to be primarily responsible for the act of micturition and "the sympathetic nerve supply is apparently not essential to the function of micturition...."10 Clearly, however, it can be assumed that abnormal autonomic function was the basis for this patient's urinary retention. 2. Winkler, A. W., and Crankshaw, O. F.: Chloride Depletion in Conditions Other Than Addison's Disease , J. Clin. Invest. 17:1-6 ( (Jan.) ) 1938.Crossref 3. Sims, E. A. H.; Welt, L. G.; Orloff, J., and Needham, J. W.: Asymptomatic Hyponatremia in Pulmonary Tuberculosis , J. Clin. Invest. 29:1545-1557 ( (Nov.) ) 1950.Crossref 4. Schwartz, W. B.; Bennett, W.; Curelop, S., and Bartter, F. C.: A Syndrome of Renal Sodium Loss and Hyponatremia Probably Resulting from Inappropriate Secretion of Antidiuretic Hormone , Amer. J. Med. 23:529-542 ( (Oct.) ) 1957.Crossref 5. Roberts, H. J.: The Syndrome of Hyponatremia and Renal Sodium Loss Probably Resulting from Inappropriate Secretion of Antidiuretic Hormone , Ann. Intern. Med. 51:1420-1426 ( (Dec.) ) 1959.Crossref 6. Epstein, F. H., and Levitin, H.: "Cerebral Salt-Wasting": An Example of Sustained Inappokalaemia and Hyponatraemia in a Patient with Clin. Invest. 38:1001 ( (June) ) 1959.Crossref 7. Arblaster, P. G., and Whitehead, T. P.: Hypokalaemia and Hyponatraemia in a Patient with Tuberculous Meningitis , Tubercle 38:348-350 ( (Oct.) ) 1957.Crossref 8. Rapoport, S.; West, C. D., and Brodsky, W. A.: Salt Losing Conditions: The Renal Defect in Tuberculous Meningitis , J. Lab. Clin. Med. 37: 550-561 ( (April) ) 1951. 9. Peters, J. P.; Welt, L. G.; Sims, E. A. H.; Orloff, J., and Needham, J.: A Salt-Wasting Syndrome Associated with Cerebral Disease , Trans. Ass. Amer. Physicians 63:57-63 ( (May) ) 1950. 10. Welt, L. G.; Seldin, D. W.; Nelson, W. P.; German, W. J., and Peters, J. P.: Role of Central Nervous System in Metabolism of Electrolytes and Water , A.M.A. Arch. Intern. Med. 90:355-378 ( (Sept.) ) 1952.Crossref 11. Grinker, R. R.; Bucy, P. C., and Sahs, A. L.: Vegetative Nervous System , in Neurology , Ed. 5, Springfield, Ill., Charles C Thomas, Publisher, 1960, 360 pp. 12. Cort. J. H.: Cerebral Salt Wasting , Lancet 1:752-754 ( (April 10) ) 1954.Crossref 13. Wise, B. L.: Relation of Brain Stem to Renal Electrolyte Excretion , Proc. Soc. Exp. Biol. Med. 91:557-560 ( (April) ) 1956.Crossref 14. Leaf, A., and Mamby, A. R.: The Normal Antidiuretic Mechanism in Man and Dog: Its Regulation by Extracellular Fluid Tonicity , J. Clin. Invest. 31:54-59 ( (Jan.) ) 1952.Crossref 15. del Greco, F., and de Wardener, H. E.: The Effect on Urine Osmolarity of a Transient Reduction in Glomerular Filtration Rate and Solute Output During a "Water" Diuresis , J. Physiol. 131:307-316 ( (Feb.) ) 1956. 16. Berliner, R. W., and Davidson, D. G.: Production of Hypertonic Urine in the Absence of Pituitary Antidiuretic Hormone , J. Clin. Invest. 34:690 ( (June) ) 1956. 17. Verney, E. B.: Absorption and Excretion of Water: The Antidiuretic Hormone , Lancet 2:739-744 ( (Nov. 23) ); 781-783 (Nov. 30) 1946.Crossref 18. Verney, E. B.: Croonian Lecture: The Antidiuretic Hormone and the Factors Which Determine Its Release , Proc. Roy. Soc. Med. 135:25-106 ( (Dec. 16) ) 1947.Crossref 19. Leaf, A., and Mamby, A. R.: An Antidiuretic Mechanism Not Regulated by Extracellular Fluid Tonicity , J. Clin. Invest. 31:60-71 ( (Jan.) ) 1952.Crossref 20. Leaf, A.; Bartter, F. C.; Santos, R. F., and Wrong, O.: Evidence in Man That Urinary Electrolyte Loss Induced by Pitressin Is a Function of Water Retention , J. Clin. Invest. 32:868-878 ( (Sept.) ) 1953.Crossref 21. Bartter, F. C.; Mills, I. H.; Biglieri, E. G., and Delea, C.: Studies on the Control and Physiologic Action of Aldosterone , in Recent Progress in Hormone Research , New York, Academic Press, Inc., 1959, Vol. 15, p. 328. 22. Kaplan, S. A., and Rapoport, S.: Urinary Excretion of Sodium and Chloride After Splanchnicotomy: Effect of the Proximal Tubule , Amer. J. Physiol. 164:175-181 ( (Jan.) ) 1951. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Renal Sodium Loss and Bronchogenic Carcinoma: Associated Autonomic Neuropathy

IVY, HORACE K.
Archives of Internal Medicine , Volume 108 (1) – Jul 1, 1961
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References (24)

Publisher
American Medical Association
Copyright
Copyright © 1961 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1961.03620070049007
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Abstract

Abstract The association of renal loss of sodium with diseases of the lungs has been reported for some years. Winkler and Crankshaw,1 in 1938, called attention to 15 cases of pulmonary tuberculosis in which low-serum chloride levels were associated with increased urinary losses of chloride. From their data they inferred that serum sodium levels were depressed too, and that urinary losses of sodium were excessive. They reported also a similar condition in a patient having carcinoma of the lung with a complicating mycotic infection. Since then, further attention has been drawn to the association of hyponatremia and pulmonary tuberculosis.2 In 1957 Schwartz and associates3 reported 2 cases of bronchogenic carcinoma in which hyponatremia developed because of an unexplained failure of renal sodium conservation. From their studies they concluded that the renal sodium loss was due to continued inappropriate secretion of antidiuretic hormone (ADH). In 1959 Roberts4 reported References 1. Urinary retention in the absence of demonstrable obstruction must be assumed to have a neurogenic basis. Parasympathetic innervation is thought to be primarily responsible for the act of micturition and "the sympathetic nerve supply is apparently not essential to the function of micturition...."10 Clearly, however, it can be assumed that abnormal autonomic function was the basis for this patient's urinary retention. 2. Winkler, A. W., and Crankshaw, O. F.: Chloride Depletion in Conditions Other Than Addison's Disease , J. Clin. Invest. 17:1-6 ( (Jan.) ) 1938.Crossref 3. Sims, E. A. H.; Welt, L. G.; Orloff, J., and Needham, J. W.: Asymptomatic Hyponatremia in Pulmonary Tuberculosis , J. Clin. Invest. 29:1545-1557 ( (Nov.) ) 1950.Crossref 4. Schwartz, W. B.; Bennett, W.; Curelop, S., and Bartter, F. C.: A Syndrome of Renal Sodium Loss and Hyponatremia Probably Resulting from Inappropriate Secretion of Antidiuretic Hormone , Amer. J. Med. 23:529-542 ( (Oct.) ) 1957.Crossref 5. Roberts, H. J.: The Syndrome of Hyponatremia and Renal Sodium Loss Probably Resulting from Inappropriate Secretion of Antidiuretic Hormone , Ann. Intern. Med. 51:1420-1426 ( (Dec.) ) 1959.Crossref 6. Epstein, F. H., and Levitin, H.: "Cerebral Salt-Wasting": An Example of Sustained Inappokalaemia and Hyponatraemia in a Patient with Clin. Invest. 38:1001 ( (June) ) 1959.Crossref 7. Arblaster, P. G., and Whitehead, T. P.: Hypokalaemia and Hyponatraemia in a Patient with Tuberculous Meningitis , Tubercle 38:348-350 ( (Oct.) ) 1957.Crossref 8. Rapoport, S.; West, C. D., and Brodsky, W. A.: Salt Losing Conditions: The Renal Defect in Tuberculous Meningitis , J. Lab. Clin. Med. 37: 550-561 ( (April) ) 1951. 9. Peters, J. P.; Welt, L. G.; Sims, E. A. H.; Orloff, J., and Needham, J.: A Salt-Wasting Syndrome Associated with Cerebral Disease , Trans. Ass. Amer. Physicians 63:57-63 ( (May) ) 1950. 10. Welt, L. G.; Seldin, D. W.; Nelson, W. P.; German, W. J., and Peters, J. P.: Role of Central Nervous System in Metabolism of Electrolytes and Water , A.M.A. Arch. Intern. Med. 90:355-378 ( (Sept.) ) 1952.Crossref 11. Grinker, R. R.; Bucy, P. C., and Sahs, A. L.: Vegetative Nervous System , in Neurology , Ed. 5, Springfield, Ill., Charles C Thomas, Publisher, 1960, 360 pp. 12. Cort. J. H.: Cerebral Salt Wasting , Lancet 1:752-754 ( (April 10) ) 1954.Crossref 13. Wise, B. L.: Relation of Brain Stem to Renal Electrolyte Excretion , Proc. Soc. Exp. Biol. Med. 91:557-560 ( (April) ) 1956.Crossref 14. Leaf, A., and Mamby, A. R.: The Normal Antidiuretic Mechanism in Man and Dog: Its Regulation by Extracellular Fluid Tonicity , J. Clin. Invest. 31:54-59 ( (Jan.) ) 1952.Crossref 15. del Greco, F., and de Wardener, H. E.: The Effect on Urine Osmolarity of a Transient Reduction in Glomerular Filtration Rate and Solute Output During a "Water" Diuresis , J. Physiol. 131:307-316 ( (Feb.) ) 1956. 16. Berliner, R. W., and Davidson, D. G.: Production of Hypertonic Urine in the Absence of Pituitary Antidiuretic Hormone , J. Clin. Invest. 34:690 ( (June) ) 1956. 17. Verney, E. B.: Absorption and Excretion of Water: The Antidiuretic Hormone , Lancet 2:739-744 ( (Nov. 23) ); 781-783 (Nov. 30) 1946.Crossref 18. Verney, E. B.: Croonian Lecture: The Antidiuretic Hormone and the Factors Which Determine Its Release , Proc. Roy. Soc. Med. 135:25-106 ( (Dec. 16) ) 1947.Crossref 19. Leaf, A., and Mamby, A. R.: An Antidiuretic Mechanism Not Regulated by Extracellular Fluid Tonicity , J. Clin. Invest. 31:60-71 ( (Jan.) ) 1952.Crossref 20. Leaf, A.; Bartter, F. C.; Santos, R. F., and Wrong, O.: Evidence in Man That Urinary Electrolyte Loss Induced by Pitressin Is a Function of Water Retention , J. Clin. Invest. 32:868-878 ( (Sept.) ) 1953.Crossref 21. Bartter, F. C.; Mills, I. H.; Biglieri, E. G., and Delea, C.: Studies on the Control and Physiologic Action of Aldosterone , in Recent Progress in Hormone Research , New York, Academic Press, Inc., 1959, Vol. 15, p. 328. 22. Kaplan, S. A., and Rapoport, S.: Urinary Excretion of Sodium and Chloride After Splanchnicotomy: Effect of the Proximal Tubule , Amer. J. Physiol. 164:175-181 ( (Jan.) ) 1951.

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Archives of Internal Medicine – American Medical Association

Published: Jul 1, 1961

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