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June 1962

Renal Function in Diabetes InsipidusCase Untreated for Seventeen Years

Author Affiliations


USPHS Fellow in Hematology, Presbyterian Hospital, New York. Formerly Regimental Surgeon, 504th Parachute Infantry Regiment.

Arch Intern Med. 1962;109(6):717-723. doi:10.1001/archinte.1962.03620180079009

Diabetes insipidus is an infrequent syndrome due to a deficiency of the antidiuretic hormone (ADH) and secondary to malfunction of the hypothalamo-neurohypophyseal system. The observation that a lesion must destroy the supraoptic nuclei bilaterally or interrupt the nerve tracts connecting these nuclei with the neurohypophysis supports the contention that the hormone is produced in the hypothalamus and stored in the posterior pituitary.1 ADH is released in response to osmoreceptors located in the hypothalamus, and it has been possible to differentiate the syndrome resulting from primary failure of the osmoreceptors from that due to a deficiency of the hormone itself.2 Primary and secondary forms of the syndrome exist, and postmortem examination will demonstrate a lesion in the hypothalamo-neurohypophyseal system in a large percentage of cases. Granulomatous or metastatic infiltration is most commonly found.3 The primary or idiopathic form, which may occur on a hereditary basis, usually appears in

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