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Primary Polydipsia: Syndrome of Inappropriate Thirst

Primary Polydipsia: Syndrome of Inappropriate Thirst Abstract • A patient with lifelong severe polyuria and polydipsia had normal serum antidiuretic hormone (ADH) levels and responded to water deprivation with a prompt increase in urine osmolality and maintenance of normal plasma osmolality (<290 mOsm/kg), despite extreme thirst. When treated with desmopressin acetate and allowed free access to water, she was able to reduce plasma osmolality below 270 mOsm/kg, and her compelling thirst disappeared. The disorder is interpreted to be the result of excessive fluid intake in response to a thirst stimulus that was not inhibited by normal plasma osmolality. This study indicates that osmoreceptor control of ADH secretion is normal. Continued administration of vasopressin has relieved the symptoms and has not resulted in water intoxication. (Arch Intern Med 1983;143:1249-1251) References 1. Martin JB, Reichlin S, Brown GM: Neuroregulation of water and salt metabolism: Physiologic function and disease , in Clinical Neuroendocrinology . Philadelphia, FA Davis Co, 1977, p 80. 2. Barlow ED, DeWardener HE: Compulsive water drinking. Q J Med 1959;28:235-258. 3. Fitzsimmons JT: Thirst. Physiol Rev 1972;52:468-561. 4. Stuart CA, Neelson FA, Lebovitz HE: Disordered control of thirst in hypothalamic-pituitary sarcoidosis. N Engl J Med 1980;303:1078-1082.Crossref 5. Robertson GL: Diseases of the posterior pituitary , in Felig P, Baxter JD, Broadus AE, et al (eds): Endocrinology and Metabolism . New York, McGraw-Hill Book Co, 1981, pp 251-277. 6. Miller M, Dalakos T, Moses AM, et al: Recognition of partial defects in antidiuretic hormone secretion. Ann Intern Med 1970;73:721-729.Crossref 7. Zerbe RL, Robertson GL: A comparison of plasma vasopressin measurements with a standard indirect test in the differential diagnosis of polyuria. N Engl J Med 1981;305:1539-1546.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Primary Polydipsia: Syndrome of Inappropriate Thirst

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Publisher
American Medical Association
Copyright
Copyright © 1983 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1983.00350060181030
Publisher site
See Article on Publisher Site

Abstract

Abstract • A patient with lifelong severe polyuria and polydipsia had normal serum antidiuretic hormone (ADH) levels and responded to water deprivation with a prompt increase in urine osmolality and maintenance of normal plasma osmolality (<290 mOsm/kg), despite extreme thirst. When treated with desmopressin acetate and allowed free access to water, she was able to reduce plasma osmolality below 270 mOsm/kg, and her compelling thirst disappeared. The disorder is interpreted to be the result of excessive fluid intake in response to a thirst stimulus that was not inhibited by normal plasma osmolality. This study indicates that osmoreceptor control of ADH secretion is normal. Continued administration of vasopressin has relieved the symptoms and has not resulted in water intoxication. (Arch Intern Med 1983;143:1249-1251) References 1. Martin JB, Reichlin S, Brown GM: Neuroregulation of water and salt metabolism: Physiologic function and disease , in Clinical Neuroendocrinology . Philadelphia, FA Davis Co, 1977, p 80. 2. Barlow ED, DeWardener HE: Compulsive water drinking. Q J Med 1959;28:235-258. 3. Fitzsimmons JT: Thirst. Physiol Rev 1972;52:468-561. 4. Stuart CA, Neelson FA, Lebovitz HE: Disordered control of thirst in hypothalamic-pituitary sarcoidosis. N Engl J Med 1980;303:1078-1082.Crossref 5. Robertson GL: Diseases of the posterior pituitary , in Felig P, Baxter JD, Broadus AE, et al (eds): Endocrinology and Metabolism . New York, McGraw-Hill Book Co, 1981, pp 251-277. 6. Miller M, Dalakos T, Moses AM, et al: Recognition of partial defects in antidiuretic hormone secretion. Ann Intern Med 1970;73:721-729.Crossref 7. Zerbe RL, Robertson GL: A comparison of plasma vasopressin measurements with a standard indirect test in the differential diagnosis of polyuria. N Engl J Med 1981;305:1539-1546.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Jun 1, 1983

References