This paper is only available as a PDF. To read, Please Download here.
Abstract
Eight children with histiocytosis X who had diabetes insipidus were tested for their
ability to respond to water deprivation. Four children were examples of the classic
absence of osmotic threshold and lack of urinary concentrating ability. Although 4
children had clinical signs of polyuria and polydipsia, their osmotic thresholds and
urinary concentrating abilities after various periods of water deprivation indicated
residual vasopressin activity (partial diabetes insipidus). The spectrum of functional
impairment in this latter group of patients with partial diabetes insipidus includes
patients with a decreased response to water deprivation, one of whom also demonstrated
an increased threshold for antidiuretic function and one patient with a specific failure
of osmotic receptors. During the period of observation, one patient progressed from
partial to complete loss of function, and one child in the control group developed
partial diabetes insipidus. The symptoms of polyuria and polydipsia must be taken
as indicative of a significant but not necessarily total hypofunction of the water-conserving
mechanism. In view of our experience with failure of the hypertonic saline infusion
test and the simple 8 hour water-deprivation test to delineate the extent of damage,
a more extensive evaluation of water metabolism in all patients having polyuria and
polydipsia is recommended.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Translational ResearchAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Differentiation of polyuric states by measurement of responses to changes in plasma osmolality induced by hypertonic saline infusions.Amer J Med. 1967; 42: 368-377
- Measurement of the osmotic threshold for vasopressin release in human subjects, and its modification by cortisol.J Clin Endocrin. 1965; 25: 1481-1492
- A standardized test of renal concentrating capacity in children.Amer J Dis Child. 1967; 114: 639-644
- A water deprivation test for the diagnosis of diabetes insipidus in children.Amer J Dis Child. 1967; 114: 157-160
- The osmotic concentrating ability in healthy infants and children.Arch Dis Child. 1965; 40: 291-295
- Determination of renal concentration capacity in infants and children without renal disease.Acta Paediat. 1959; 48: 318-328
- Renal concentrating mechanisms in newborn infants.J Clin Invest. 1960; 39: 1062-1069
- The 24-hour true endogenous creatinine clearance in infants and children without renal disease.Acta Paediat. 1959; 48: 443-452
- Diseases of the kidney. Little, Brown & Company, Boston1963: 105
- The influence of bodily hydration on the renal concentrating process.J Clin Invest. 1957; 36: 629-634
- On the nature of the renal concentrating defect in malnutrition.Amer J Med. 1967; 43: 84-96
- The clinical physiology of water metabolism.New Eng J Med. 1967; 277: 1300-1307
- Hand-Schüller-Christian disease with occult diabetes insipidus.Arch Int Med. 1965; 116: 131-137
- Histiocytosis X (Schüller-Christian Disease): A clinico-pathological survey, review of ten patients, and the results of prednisone therapy.Medicine. 1963; 42: 119-147
- Hypernatremia due to hypodipsia and elevated threshold for vasopressin release.New Eng J Med. 1968; 279: 1191-1196
- The regulation of antidiuretic hormone release in man.J Clin Invest. 1968; 47: 2143-2151
- Mechanisms of antidiuretic hormone (ADH) control of importance to the surgical patient.Surgery. 1967; 62: 639-644
Article info
Publication history
Accepted:
April 28,
1971
Received:
April 8,
1970
Footnotes
☆Supported by United States Health Service Grants Nos. CA-08101, CA-08832, and CA-07306.
Identification
Copyright
© 1971 Published by Elsevier Inc.
