Unstable osmoreceptors and defective thirst in hypothalamic hypopituitarism. 1981

Z Hochberg, and R A Richman

An 8-year-old girl with hypothalamic hypopituitarism is described. The clinical course was characterized by fluctuation between diabetes insipidus and water intoxication. In an attempt to find a physiological explanation she underwent two sets of dehydration and osmotic threshold tests. The presence of endogenous vasopressin, and the normally functioning volume receptors, was demonstrated by the normal urine osmolality during dehydration. The osmotic threshold was 263 mosm/kg on one test and 300 mosm/kg on the other. More extreme values might be suspected based on simultaneous urine and plasma osmolality obtained during acute episodes of water intoxication and severe dehydration. With plasma osmolality as high as 307 mosm/kg, the child denied thirst. The data appear to indicate an instability of the osmoreceptor mechanism and a deficiency of the thirst mechanism with intact volume receptors.

UI MeSH Term Description Entries
D007018 Hypopituitarism Diminution or cessation of secretion of one or more hormones from the anterior pituitary gland (including LH; FOLLICLE STIMULATING HORMONE; SOMATOTROPIN; and CORTICOTROPIN). This may result from surgical or radiation ablation, non-secretory PITUITARY NEOPLASMS, metastatic tumors, infarction, PITUITARY APOPLEXY, infiltrative or granulomatous processes, and other conditions. Adenohypophyseal Hyposecretion,Anterior Pituitary Hyposecretion Syndrome,Sheehan Syndrome,Simmonds Disease,Hyposecretion Syndrome, Anterior Pituitary,Hyposecretion, Adenohypophyseal,Pituitary Insufficiency,Postpartum Hypopituitarism,Postpartum Panhypopituitarism,Postpartum Pituitary Insufficiency,Sheehan's Syndrome,Simmonds' Disease,Disease, Simmonds,Hypopituitarism, Postpartum,Insufficiency, Pituitary,Panhypopituitarism, Postpartum,Pituitary Insufficiency, Postpartum,Sheehans Syndrome,Simmond's Disease,Syndrome, Sheehan,Syndrome, Sheehan's
D007700 Kinetics The rate dynamics in chemical or physical systems.
D009994 Osmolar Concentration The concentration of osmotically active particles in solution expressed in terms of osmoles of solute per liter of solution. Osmolality is expressed in terms of osmoles of solute per kilogram of solvent. Ionic Strength,Osmolality,Osmolarity,Concentration, Osmolar,Concentrations, Osmolar,Ionic Strengths,Osmolalities,Osmolar Concentrations,Osmolarities,Strength, Ionic,Strengths, Ionic
D010903 Pituitary Gland, Anterior The anterior glandular lobe of the pituitary gland, also known as the adenohypophysis. It secretes the ADENOHYPOPHYSEAL HORMONES that regulate vital functions such as GROWTH; METABOLISM; and REPRODUCTION. Adenohypophysis,Anterior Lobe of Pituitary,Anterior Pituitary Gland,Lobus Anterior,Pars Distalis of Pituitary,Adenohypophyses,Anterior Pituitary Glands,Anterior, Lobus,Anteriors, Lobus,Lobus Anteriors,Pituitary Anterior Lobe,Pituitary Glands, Anterior,Pituitary Pars Distalis
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D003681 Dehydration The condition that results from excessive loss of water from a living organism. Water Stress,Stress, Water
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013894 Thirst A drive stemming from a physiological need for WATER. Thirsts
D014869 Water Intoxication A condition resulting from the excessive retention of water with sodium depletion. Hyperhydration,Overhydration

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