항이뇨 호르몬 분비 저하를 동반한 무갈증성 고나트륨혈증 1예
Adipsic Hypernatremia Associated with Deficiency of Antidiuretic Hormone Release
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초록
무갈증성 고나트륨혈증은 갈증을 유발하는 삼투압 수용체의 기능 이상으로 발생하는 드문 질환으로 항이뇨 호르몬의 분비 저하를 동반하기도 한다. 저자들은 전신 쇠약감으로내원한 69세 여자 환자에서 두개 내 병변 없이 항이뇨 호르몬의 분비 저하를 동반한 무갈증성 고나트륨혈증 1예를 국내에서 처음으로 경험하였기에 문헌고찰과 함께 보고하고자한다.
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.
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