MICHAEL GEHEB, M.D.; MALCOLM COX, M.D.; IRWIN SINGER, M.D.
To the editor: Sheeler and Schumacher report in the May issue (1) three cases of severe hyponatremia (101, 109, and 116 meq/L) associated with infusions of ACTH in which a limited volume of 5% dextrose in water was given intravenously as the carrier. Even assuming that renal water excretion was negligible, serum antidiuretic hormone (ADH) levels were maximal, and all three patients were small in size, the decrease in serum sodium concentration cannot be accounted for by the amount of water infused in any of these cases. Assuming a body weight of 50 kg, which is small for an adult,
GEHEB M, COX M, SINGER I. Hyponatremia During ACTH Infusions. Ann Intern Med. ;91:792. doi: 10.7326/0003-4819-91-5-792_1
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Published: Ann Intern Med. 1979;91(5):792.
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