ADH imbalance may occur in patients after pituitary surgery. Two cases are presented that demonstrate the problems associated with the disturbance of water metabolism. The medical management of these patients is discussed, with emphasis on the importance of the correct choice of pharmacological agents to control the manifestations of ADH imbalance.
DanielPMPrichardMML. Studies of the hypothalamus and the pituitary gland with special reference to the effects of transection of the pituitary stalk. Acta Endocrinol1975; 80:(suppl 201).
2.
RandallRVClarkECDodgeHWLoveJG. Polyuria after operation for tumors in the region of the hypophysis and hypothalamus. J Clin Endocrinol1960; 20: 1614–21.
3.
FreidenbergGRKosnikEJSotosJF. Hyperglycaemia coma after suprasellar surgery. N Engl J Med1980; 303: 863–5.
4.
ArieffAIGuisadoR. Effects on the central nervous system of hypernatraemic and hyponatraemic states. Kidney Int1976; 10: 104–16.
5.
HantmanDRossierBZohlmanRSchrierR. Rapid correction of hyponatraemia in the syndrome of inappropriate secretion of antidiuretic hormone. Ann Intern Med1973; 78: 870–5.
6.
ForrestJNCoxMHongCMorrisonGBiaMSingerI. Superiority of demeclocycline over lithium in the treatment of chronic syndrome of inappropriate secretion of antidiuretic hormone. N Engl J Med1978; 298: 173–7.
7.
FowlerRCKronfalZAPerryPJ. Water intoxication, psychosis and inappropriate secretion of antidiuretic hormone. Arch Gen Psychiatry1977; 34: 1097–9.
8.
HockadayTDR. Diabetes insipidus. Br Med J1972; 2: 210–3.
9.
PullanPTBurgerHGJohnstonCI. Pharmacokinetics of l-desamino-8-D-arginine vasopressin (DDAVP) in patients with central diabetes insipidus. Clin Endocrinol1978; 9: 273–8.
10.
ArduinoFFerrazFPJRodriguesJ. Antidiuretic action of chlorpropamide in idiopathic diabetes insipidus. J Clin Endocrinol Metab1966; 26: 1325–8.
11.
MillerMMosesAM. Mechanism of chlorpropamide action in diabetes insipidus. J Clin Endocrinol Metab1970; 30: 488–96.
12.
Chlorpropamide in diabetes insipidus. Br Med J1971; 1: 302–3.
13.
RadoJP. Combination of carbamazepine and chlorpropamide in the treatment of hypo-responder pituitary diabetes insipidus. J Clin Endocrinol1974; 38: 1–7.
14.
WeissmanPNShenkmanLGregermanRI. Chlorpropamide hyponatraemia. N Engl J Med1971; 284: 65–71.
15.
CenottiGAStiratiGRuggieroR. Abnormal water retention and symptomatic hyponatraemia in idiopathic diabetes insipidus during chlorpropamide therapy. Postgrad Med J1972; 48: 107–12.
16.
MahoneyJHGoodmanAD. Hypernatraemia due to hypodipsia and elevated threshold for vasopressin release. N Engl J Med1968; 279: 1191–6.
17.
RadoJPBorbelyL. Enhancement of polyuria by glibenclamide in diabetes insipidus (letter). Lancet1971; 2: 216.
18.
WalesJK. Treatment of diabetes insipidus with carbamazepine. Lancet1975; 2: 948–51.
19.
RadoJP. Water intoxication during carbamazepine treatment. Br Med J1973; 3: 479.
20.
StephensWPEspirMLCTattersallRB. Water intoxication due to carbamazepine. Br Med J1977; 1: 754–5.
CrawfordJDKennedyGC. Animal physiology: chlorothiazide in diabetes insipidus. Nature1959; 183: 891–2.
23.
EarleyLEOrloffJ. Thiazide diuretics. Annu Rev Med1964; 15: 149–66.
24.
EarleyLEOrloffJ. The mechanism of antidiuresis associated with the administration of hydrochlorothiazide to patients with vasopressin-resistant diabetes insipidus. J Clin Invest Invest1962; 41: 1988–97.
25.
FichmanMPVorherrHKleemanCRTelferN. Diuretic-induced hyponatraemia. Ann Intern Med1971; 75: 853–63.
26.
KennedyRMEarleyLE. Profound hyponatraemia resulting from a thiazide induced decrease in urinary diluting capacity in a patient with primary polydipsia. N Engl J Med1970; 282: 1185–7.
27.
LuzeckyMHBurmanKD. Schulz ER. The syndrome of inappropriate secretion of antidiuretic hormone associated with amitriptyline administration. South Med J1974; 67: 495–7.
De RiveraJG. Inappropriate secretion of antidiuretic hormone from fluphenazine therapy. Ann Intern Med1975; 82: 811–2.
30.
RaoKJMillerMMosesA. Water intoxication and thioridazine. Ann Intern Med1975; 82: 61–3.
31.
CohenIM. Complications of chlorpromazine therapy. Am J Psychiatry1956; 113: 115–21.
32.
CuttingHO. Inappropriate secretion of antidiuretic hormone secondary to vincristine therapy. Am J Med1971; 51: 269–71.
33.
De FronzoRABraineJColvinOMDavisPJ. Water intoxication in man after cyclophosphamide therapy: time course and relation to drug activation. Ann Intern Med1973; 78: 861–9.
