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Plasma arginine vasopressin in the syndrome of antidiuretic hormone excess associated with bronchogenic carcinoma

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      Abstract

      A study of plasma arginine vasopressin in 17 patients with the syndrome of inappropriate antidiuretic hormone secretion (SIADH) associated with bronchogenic carcinoma, revealed that the arginine vasopressin levels were distinctly elevated in most. In 14 patients with bronchogenic carcinoma, but without overt SIADH, plasma levels of arginine vasopressin were significantly higher than in normal subjects (p < 0.001). This, together with the finding of a lower than normal plasma osmolality in this group, suggests that inappropriate ADH excess might be much more common in patients with bronchogenic carcinoma than previously thought.
      The normal positive correlation between plasma osmolality and plasma arginine vasopressin was found to be reversed in SIADH. Seven of nine patients with overt SIADH, studied after fluid deprivation, showed an increase in plasma arginine vasopressin coincident with an increase in plasma osmolality (r = + 0.8, p < 0.01); in one patient, plasma arginine vasopressin returned to the original level following rehydration. The possibility that this might imply a degree of physiologic control to what is generally considered an autonomous secretion is discussed. It is, however, considered more likely that other factors, including changes in plasma volume and glomerular filtration, might explain the increase in plasma levels of arginine vasopressin.
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      References

        • Winkler AW
        • Crankshaw OF
        Chloride depletion in conditions other than Addisons disease.
        J Clin Invest. 1938; 17: 1
        • Schwartz WB
        • Bennet W
        • Curelop S
        • Bartter FC
        A syndrome of renal sodium loss and hyponatraemia probably resulting from inappropriate secretion of antidiuretic hormone.
        Am J Med. 1957; 23: 529
        • Bartter FC
        • Schwartz WB
        The syndrome of inappropriate secretion of antidiuretic hormone.
        Am J Med. 1967; 42: 790
        • Leaf A
        • Bartter FC
        • Santos RF
        • et al.
        Evidence in man that urinary electrolyte loss induced by pitressin is a function of water retention.
        J Clin Invest. 1953; 32: 868
        • Azzopardi JG
        • Freeman E
        • Poole G
        Endocrine and metabolic disorders in bronchial carcinoma.
        Br Med J. 1970; 4: 528
        • Morton JJ
        • Padfield PL
        • Forsling ML
        A radioimmunoassay for plasma arginine vasopressin in man and dog: Application to physiological and pathological states.
        J Endocr. 1975; 65: 411
        • Anderson SB
        Simultaneous determination of plasma volume with 131I labelled gamma-globulin, 131I labelled albumin and T-1824.
        Clin Sci. 1962; 23: 221
        • Amatruda TT
        • Mulrow PJ
        • Gallacher JC
        • et al.
        Carcinoma of the lung with inappropriate antidiuresis' Demonstration of antidiuretic hormone-like activity in tumour extract.
        N Engl J Med. 1963; 269: 544
        • Vorherr H
        • Massry SG
        • Utiger RD
        • et al.
        Antidiuretic principle in malignant tumour extracts from patients with inappropriate ADH syndrome.
        J Clin Endocrinol. 1968; 28: 162
        • Baumann G
        • Lopez-Amor E
        • Dingman JF
        Plasma arginine vasopressin in the syndrome of inappropriate antidiuretic hormone secretion.
        Am J Med. 1972; 52: 19
        • Miller M
        • Moses AM
        Urinary antidiuretic hormone in polyuric disorders and in inappropriate ADH syndrome.
        Ann Intern Med. 1972; 77: 715
        • Skowsky WR
        • Rosenbloom AA
        • Fisher DA
        Radioimmunoassay measurement of arginine vasopressin in serum: Development and application.
        J Clin Endocrinol. 1974; 38: 278
        • Vorherr H
        • Vorherr UF
        • McConnell TS
        • et al.
        Localisation and origin of antidiuretic principle in para-endocrine active malignant tumours.
        Oncology (Basel). 1974; 29: 201
        • George JM
        • Capen CC
        • Phillips AS
        Biosynthesis of vasopressin in vtiro and ultrastructure of a bronchogenic carcinoma.
        J Clin Invest. 1972; 51: 141
        • Hamilton BPM
        • Upton CV
        • Amatruda TT
        Evidence for the presence of neurophysin in tumours producing the syndrome of inappropriate antidiuresis.
        J Clin Endocrinol. 1972; 35: 764
        • Lipscomb HS
        • Wilson C
        • Retiene K
        • et al.
        The syndrome of inappropriate antidiuretic hormone release' A case report and characteristics of the antidiuretic hormone-like material isolated from an oat cell carcinoma of the lung.
        Cancer Res. 1968; 28: 378
        • Sawyer WH
        Pharmacological characteristics of the antidiuretic principle in a bronchogenic carcinoma from a patient with hyponatraemia.
        J Clin Endocrinol. 1967; 27: 1497
        • Verney EB
        The antidiuretic hormone and the factors which determine its release.
        in: 5th ed. Proc Roy Soc. 135. 1947: 25
        • Pasqualini RQ
        • Codevilla A
        Thirst suppressing “Antidipsetic”) effect of pitressin in diabetes insipidus.
        Acta Endocrinol. 1959; 30: 37
        • Adolph EF
        • Barker JP
        • Keller AD
        Thirst tests in dogs and modifications of thirst with experimental lesions of the neurohypophyses.
        Am J Physiol. 1959; 173: 233
        • Fitzsimons JT
        Thirst.
        Physiol Rev. 1972; 52: 468
        • Szczepanska SE
        • Kozlowski S
        • Sobocinska J
        Blood antidiuretic hormone level and osmotic reactivity of thirst mechanism in dogs.
        Am J Physiol. 1974; 227: 766
        • Segar WE
        • Moore WW
        Increased antidiuretic hormone and “inappropriate” thirst in a patient with bronchogenic carcinoma.
        Minerva Med. 1968; 5: 625
        • Bartter FC
        The syndrome of inappropriate secretion of antidiuretic hormone (SIADH).
        in: Nov 1973: 1 (DM)
        • Carter NW
        • Rector FC
        • Seidin DW
        Hyponatraemia in cerebral disease resulting from the inappropriate secretion of antidiuretic hormone.
        N Engl J Med. 1961; 264: 67
        • Clift GV
        • Schletter FE
        • Moses AM
        • et al.
        Syndrome of inappropriate vasopressin secretion.
        Arch Intern Med. 1966; 118: 453
        • De Sousa RC
        • Delaere J
        • Thaon A
        • Rudier JC
        • Mach RS
        Le syndrome de Schwartz-Bartter. Carcinome du poumon avec secretion inadequate d.hormone antidiuretique.
        Schweiz Med Wochneschr. 1964; 94: 1805
        • Grantham JJ
        • Brown RW
        • Schloerb PR
        Asymptomatic hyponatraemia and bronchogenic carcinoma: The deleterious effects of diuretics.
        Am J Med Sci. 1965; 249: 273
        • Ginsburg M
        • Heller H
        The clearance of injected vasopressin from the circulation and its fate in the body.
        J Endocrinol. 1953; 9: 283
        • Lauson HD
        Metabolism of antidiuretic hormones.
        Am J Med. 1967; 42: 713
        • Bower BF
        • Mason DM
        • Forsham PH
        Bronchogenic carcinoma with inappropriate antidiuretic activity in plasma and tumor.
        N Engl J Med. 1964; 271: 934
        • Lee J
        • Jones JJ
        • Barraclough MA
        Inappropriate secretion of vasopressin.
        Lancet. 1964; 2: 792
        • De Sousa RC
        • Delaere J
        • Berde B
        Inappropriate secretion of vasopressin.
        Lancet. 1965; 1: 436
        • Utiger RD
        Inappropriate antidiuresis and carcinoma of the lung, Detection of arginine vasopressin in tumour extract by immunoassay.
        J Clin Endocrinol. 1966; 26: 970
        • Barraclough MA
        • Jones JJ
        • Lee J
        Production of vasopressin by anaplastic oat cell carcinoma of the bronchus.
        Clin Sci. 1966; 31: 135
        • Marks LJ
        • Berde B
        • Klein LA
        • et al.
        Inappropriate vasopressin secretion and carcinoma of the pancreas.
        Am J Med. 1968; 45: 967
        • Beardwell CG
        Radioimmunoassay of arginine vasopressin in human plasma.
        J Clin Endocrinol. 1971; 33: 254