JEFFREY BODACK, M.D.
To the editor: In the recent paper by Vagenakis, Dole, and Braverman, "Pituitary Enlargement, Pituitary Failure, and Primary Hypothyroidism" (Ann Intern Med 85:195-198, 1976), the authors state that their second patient suffered from the inappropriate ADH syndrome (1), with sodium concentrations considerably below 130 meq/litre, elevated urine osmolality, and urine sodium in excess of 120 meq/litre. However, this patient's serum cortisols were undetectable, and his renal function was never clearly described.
At our hospital, Dr. Albert, a nephrologist, states that adrenal function must be clearly delineated before the diagnosis of inappropriate ADH syndrome is made, as adrenocortical crisis might be
JEFFREY BODACK. Syndrome of Inappropriate Secretion of Antidiuretic Hormone. Ann Intern Med. 1976;85:829–830. doi: 10.7326/0003-4819-85-6-829_3
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Published: Ann Intern Med. 1976;85(6):829-830.
Endocrine and Metabolism, Fluid and Electrolyte Disorders, Nephrology, Neurology.
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