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KMID : 0882420130850030313
Korean Journal of Medicine
2013 Volume.85 No. 3 p.313 ~ p.317
Adipsic Hypernatremia Associated with Deficiency of Antidiuretic Hormone Release
Choi Myung-Jin

Kwak Kyong-Min
Park Min-Sun
Shin Won-Jae
Eom Jeong-Ho
Yoon Jong-Woo
Koo Ja-Ryong
Abstract
Adipsic hypernatremia is a rare disorder of hypothalamic osmoreceptor dysfunction for thirst. It is frequently associated with a deficiency in antidiuretic hormone (ADH) release. We report the first case in Korea of adipsic hypernatremia combined with subnormal ADH response to osmotic stimuli without any demonstrable structural lesion. A 69?year?old woman was admitted to the hospital with general weakness. In a hypernatremic hyperosmolar state, she denied thirst and did not drink spontaneously. Her plasma ADH level was markedly subnormal but she had no large volume of dilute urine. Investigation of osmoregulation by infusion of hypertonic saline revealed adipsia and an absolute deficiency in antidiuretic hormone release, despite a serum osmolarity in excess of 321 mOsmol/kg. There was no structural lesion of the hypothalamus and no abnormal finding in hypothalamic?pituitary function. After diagnosis, she was treated successfully with intentional water intake alone.
KEYWORD
Hypernatremia, Thirst, Antidiuretic hormone
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