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Studies on the Mechanism of the Hyponatremia in a Patient

GEORGE V. CLIFT, MD; FELIX E. SCHLETTER, MD; ARNOLD M. MOSES, MD; DAVID H. P. STREETEN, MB, D PHIL, MRCP

Arch Intern Med. 1966;118(5):453-460.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

CONSIDERABLE interest was aroused by the report of Schwartz et al ¹ in 1957 of two patients with hyponatremia which was attributed to "inappropriate" secretion of antidiuretic hormone (ADH). The combination of hyponatremia and a concentrated urine which these patients manifest is by no means rare being seen in adrenal insufficiency, malnutrition, and chronic debilitating illnesses of various types. In order to establish that this combination of hyponatremia and urinary hyperosmolality results from inappropriate ADH secretion, it is necessary to exclude adrenal and renal insufficiency and to show that the serum sodium concentration can be reproducibly raised and lowered by the restriction and the forcing of excessive fluid intake, respectively. As Bower et al² have pointed out, only 20 case reports have been published since 1957 which satisfy these requirements. The validity of the suggestion by Schwartz et al that inappropriate release of vasopressin-like substance is responsible for this . . . [Full Text PDF of this Article]

Author Affiliations
SYRACUSE, NY

From the Department of Medicine, State University of New York Upstate Medical Center and the Veterans Administration Hospital. Drs. Clift and Schletter were Research Fellows in Endrocrinology, trainees of the National Institute of Health.

Footnotes
Received for publication June 17, 1966; accepted Aug 3.

Reprint requests to the Department of Medicine, State University Hospital, 750 E Adams, Syracuse, NY 13210 (Dr. Streeten).

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