Korean J Med.  2013 Sep;85(3):313-317. 10.3904/kjm.2013.85.3.313.

Adipsic Hypernatremia Associated with Deficiency of Antidiuretic Hormone Release

• Choi MJ
• Kwak KM
• Park MS
• Shin WJ
• Eom JH
• Yoon JW
• Koo JR

• KMID: 1722644
• DOI: http://doi.org/10.3904/kjm.2013.85.3.313

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

MeSH Terms

Aged
Female
Humans
Hypernatremia
Hypothalamus
Korea
Osmolar Concentration
Plasma
Thirst
Water-Electrolyte Balance