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Inappropriate Antidiuretic Hormone Syndrome and Carcinoma of Pancreas with Demonstration of Tumor Antidiuretic Activity.

Leon J. Marks, M.D., F.A.C.P.; Donald C. Nabseth, M.D.; Lester A. Klein, M.D.; Jesse Roth, M.D.; and Botond Berde, M.D.
Ann Intern Med. 1968;68(5):1144-1145. doi:10.7326/0003-4819-68-5-1144_3
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A 59-year-old man with a bronchogenic carcinoma (oat cell) demonstrated inappropriate antidiuresis on the basis of [1] persistent urine hyperosmolality with marked serum hypoosmolality and hyponatremia in the presence of a normal blood volume, [2] correction of hyponatremia with water restriction, and [3] excessive natriuresis with normal renal and adrenal function. Resection of the primary lung tumor did not ameliorate the antidiuretic hormone syndrome. At autopsy, performed 4 months postoperatively, metastatic lung cancer was present in the liver, and a separate pancreatic tumor (adenocarcinoma) was found in the pancreas. Extracts of the pancreatic neoplasm contained very high levels of arginine


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