JOSEPH L. GRANT, M.D., F.A.C.P.; ALASTAIR MACDONALD; STEPHEN R. BROVENDER, M.D.; NICHOLAS YANKOPOULOS, M.D.
Both the anterior and posterior lobes of the pituitary gland affect water handling, independently of sodium. The anterior pituitary stimulates the adrenal cortex to elaborate glucocorticoid, which promotes diuresis of water loads. The posterior pituitary secretes antidiuretic hormone (ADH) that causes water retention. Recent reports (1-6) have shown that certain patients have inappropriate levels of ADH with consequent water intoxication, and it is a well-established clinical fact that diabetes insipidus never fully develops in patients with adrenal cortical insufficiency. The patient reported here brings into focus the similarity of ADH excess and glucocorticoid deficiency, and the importance of the differential
GRANT JL, MACDONALD A, BROVENDER SR, YANKOPOULOS N. Hypoadrenocorticotropism with Hyponatremia, Resembling Antidiuretic Hormone Excess. Ann Intern Med. ;63:486–494. doi: 10.7326/0003-4819-63-3-486
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Published: Ann Intern Med. 1965;63(3):486-494.
Endocrine and Metabolism, Fluid and Electrolyte Disorders, Nephrology.
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