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. 1992 Aug;67(8):998–1002. doi: 10.1136/adc.67.8.998

Plasma and cerebrospinal fluid arginine vasopressin in patients with and without fever.

P M Sharples 1, J R Seckl 1, D Human 1, S L Lightman 1, D B Dunger 1
PMCID: PMC1793597  PMID: 1520019

Abstract

Hyponatraemia has been described in association with a number of acute infectious diseases, mainly bacterial and tuberculous meningitis and pneumonia, and has been attributed to inappropriate secretion of arginine vasopressin (AVP). The mechanism of inappropriate AVP production is uncertain, but there is experimental evidence to suggest that fever may stimulate secretion of AVP into plasma and cerebrospinal fluid. In this study, AVP concentrations in plasma and cerebrospinal fluid from 37 febrile children with infections have been compared with those from 27 afebrile control subjects. Ten of the febrile children had meningitis (eight bacterial, two viral) and the remainder a variety of other infectious diseases. Seventy four per cent of febrile infected children were hyponatraemic (serum sodium less than 135 mmol/l) compared with only 8% of the afebrile controls. Plasma AVP concentrations were significantly higher in the febrile patients (median 2.92 pmol/l, range 1.0-23.25, n = 28) than in controls (median 1.67 pmol/l, range 0.57-6.0, n = 14) but there was no significant difference in cerebrospinal fluid AVP concentrations. There was no difference in plasma AVP concentrations between patients with meningitis and those with infections not involving the central nervous system. Careful attention should be paid to fluid and electrolyte balance in all children with acute infections.

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Selected References

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  1. Amico J. A., Tenicela R., Robinson A. G. Neurohypophysial hormones in cerebrospinal fluid of adults: absence of arginine vasotocin and of a diurnal rhythm of arginine vasopressin. J Clin Endocrinol Metab. 1985 Oct;61(4):794–798. doi: 10.1210/jcem-61-4-794. [DOI] [PubMed] [Google Scholar]
  2. Beisel W. R., Sawyer W. D., Ryll E. D., Crozier D. Metabolic effects of intracellular infections in man. Ann Intern Med. 1967 Oct;67(4):744–779. doi: 10.7326/0003-4819-67-4-744. [DOI] [PubMed] [Google Scholar]
  3. Bernardini G. L., Lipton J. M., Clark W. G. Intracerebroventricular and septal injections of arginine vasopressin are not antipyretic in the rabbit. Peptides. 1983 Mar-Apr;4(2):195–198. doi: 10.1016/0196-9781(83)90113-4. [DOI] [PubMed] [Google Scholar]
  4. Burrows F. A., Shutack J. G., Crone R. K. Inappropriate secretion of antidiuretic hormone in a postsurgical pediatric population. Crit Care Med. 1983 Jul;11(7):527–531. doi: 10.1097/00003246-198307000-00009. [DOI] [PubMed] [Google Scholar]
  5. Chemtob S., Reece E. R., Mills E. L. Syndrome of inappropriate secretion of antidiuretic hormone in enteroviral meningitis. Am J Dis Child. 1985 Mar;139(3):292–294. doi: 10.1001/archpedi.1985.02140050086030. [DOI] [PubMed] [Google Scholar]
  6. Cooper K. E., Kasting N. W., Lederis K., Veale W. L. Evidence supporting a role for endogenous vasopressin in natural suppression of fever in the sheep. J Physiol. 1979 Oct;295:33–45. doi: 10.1113/jphysiol.1979.sp012953. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Feigin R. D., Kaplan S. Inappropriate secretion of antidiuretic hormone in children with bacterial meningitis. Am J Clin Nutr. 1977 Sep;30(9):1482–1484. doi: 10.1093/ajcn/30.9.1482. [DOI] [PubMed] [Google Scholar]
  8. Feigin R. D., Stechenberg B. W., Chang M. J., Dunkle L. M., Wong M. L., Palkes H., Dodge P. R., Davis H. Prospective evaluation of treatment of Hemophilus influenzae meningitis. J Pediatr. 1976 Apr;88(4 Pt 1):542–548. doi: 10.1016/s0022-3476(76)80002-9. [DOI] [PubMed] [Google Scholar]
  9. GONZALEZ C. F., FINBERG L., BLUESTEIN D. D. ELECTROLYTE CONCENTRATION DURING ACUTE INFECTIONS. OBSERVATIONS IN INFANTS AND CHILDREN. Am J Dis Child. 1964 May;107:476–482. doi: 10.1001/archpedi.1964.02080060478007. [DOI] [PubMed] [Google Scholar]
  10. Garcia H., Kaplan S. L., Feigin R. D. Cerebrospinal fluid concentration of arginine vasopressin in children with bacterial meningitis. J Pediatr. 1981 Jan;98(1):67–70. doi: 10.1016/s0022-3476(81)80537-9. [DOI] [PubMed] [Google Scholar]
  11. Kasting N. W., Carr D. B., Martin J. B., Blume H., Bergland R. Changes in cerebrospinal fluid and plasma vasopressin in the febrile sheep. Can J Physiol Pharmacol. 1983 Apr;61(4):427–431. doi: 10.1139/y83-064. [DOI] [PubMed] [Google Scholar]
  12. Kasting N. W., Veale W. L., Cooper K. E., Lederis K. Vasopressin may mediate febrile convulsions. Brain Res. 1981 Jun 1;213(2):327–333. doi: 10.1016/0006-8993(81)90238-9. [DOI] [PubMed] [Google Scholar]
  13. Kruk B., Sadowski J. Antidiuretic action of intravenous and intracerebral pyrogen in conscious rabbits. J Physiol. 1978 Sep;282:429–435. doi: 10.1113/jphysiol.1978.sp012473. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Mather H. M., Ang V., Jenkins J. S. Vasopressin in plasma and CSF of patients with subarachnoid haemorrhage. J Neurol Neurosurg Psychiatry. 1981 Mar;44(3):216–219. doi: 10.1136/jnnp.44.3.216. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Naylor A. M., Cooper K. E., Veale W. L. Vasopressin and fever: evidence supporting the existence of an endogenous antipyretic system in the brain. Can J Physiol Pharmacol. 1987 Jun;65(6):1333–1338. doi: 10.1139/y87-211. [DOI] [PubMed] [Google Scholar]
  16. Potgieter P. D. Inappropriate ADH secretion in tetanus. Crit Care Med. 1983 Jun;11(6):417–418. doi: 10.1097/00003246-198306000-00003. [DOI] [PubMed] [Google Scholar]
  17. ROVIT R. L., SIGLER M. H. HYPONATREMIA WITH HERPES SIMPLEX ENCEPHALITIS. POSSIBLE RELATIONSHIP OF LIMBIC LESIONS AND ADH SECRETION. Arch Neurol. 1964 Jun;10:595–603. doi: 10.1001/archneur.1964.00460180061006. [DOI] [PubMed] [Google Scholar]
  18. Raichle M. E., Grubb R. L., Jr Regulation of brain water permeability by centrally-released vasopressin. Brain Res. 1978 Mar 17;143(1):191–194. doi: 10.1016/0006-8993(78)90766-7. [DOI] [PubMed] [Google Scholar]
  19. Raichle M. E., Grubb R. L., Jr Regulation of brain water permeability by centrally-released vasopressin. Brain Res. 1978 Mar 17;143(1):191–194. doi: 10.1016/0006-8993(78)90766-7. [DOI] [PubMed] [Google Scholar]
  20. Reingold A. L., Dan B. B., Shands K. N., Broome C. V. Toxic-shock syndrome not associated with menstruation. A review of 54 cases. Lancet. 1982 Jan 2;1(8262):1–4. doi: 10.1016/s0140-6736(82)92552-1. [DOI] [PubMed] [Google Scholar]
  21. Reynolds D. W., Dweck H. S., Cassady G. Inappropriate antidiuretic hormone secretion in a neonate with meningitis. Am J Dis Child. 1972 Mar;123(3):251–253. doi: 10.1001/archpedi.1972.02110090121021. [DOI] [PubMed] [Google Scholar]
  22. Rivers R. P., Forsling M. L., Olver R. P. Inappropriate secretion of antidiuretic hormone in infants with respiratory infections. Arch Dis Child. 1981 May;56(5):358–363. doi: 10.1136/adc.56.5.358. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Rosenow E. C., 3rd, Segar W. E., Zehr J. E. Inappropriate antidiuretic hormone secretion in pneumonia. Mayo Clin Proc. 1972 Mar;47(3):169–174. [PubMed] [Google Scholar]
  24. Seckl J., Lightman S. Cerebrospinal fluid neurohypophysial peptides in benign intracranial hypertension. J Neurol Neurosurg Psychiatry. 1988 Dec;51(12):1538–1541. doi: 10.1136/jnnp.51.12.1538. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Sexton D. J., Clapp J. Inappropriate antidiuretic hormone secretion. Occurrence in a patient with Rocky Mountain spotted fever. Arch Intern Med. 1977 Mar;137(3):362–363. doi: 10.1001/archinte.137.3.362. [DOI] [PubMed] [Google Scholar]
  26. Shann F., Germer S. Hyponatraemia associated with pneumonia or bacterial meningitis. Arch Dis Child. 1985 Oct;60(10):963–966. doi: 10.1136/adc.60.10.963. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Smith J., Godwin-Austen R. Hypersecretion of anti-diuretic hormone due to tuberculous meningitis. Postgrad Med J. 1980 Jan;56(651):41–44. doi: 10.1136/pgmj.56.651.41. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Stark H., Weinberger A. H., Ben-Bassat M. Persistent hyponatremia and inappropriate antidiuretic hormone secretion in children with extensive burns. J Pediatr Surg. 1979 Apr;14(2):149–153. doi: 10.1016/0022-3468(79)90007-1. [DOI] [PubMed] [Google Scholar]
  29. Szczepanska-Sadowska E. Plasma ADH increase and thirst suppression elicited by preoptic heating in the dog. Am J Physiol. 1974 Jan;226(1):155–161. doi: 10.1152/ajplegacy.1974.226.1.155. [DOI] [PubMed] [Google Scholar]
  30. Sørensen P. S., Gjerris A., Hammer M. Cerebrospinal fluid vasopressin in neurological and psychiatric disorders. J Neurol Neurosurg Psychiatry. 1985 Jan;48(1):50–57. doi: 10.1136/jnnp.48.1.50. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Weise K., Zaritsky A. Endocrine manifestations of critical illness in the child. Pediatr Clin North Am. 1987 Feb;34(1):119–130. doi: 10.1016/s0031-3955(16)36185-5. [DOI] [PubMed] [Google Scholar]

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