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March 1977

Inappropriate Antidiuretic Hormone Secretion: Occurrence in a Patient With Rocky Mountain Spotted Fever

Author Affiliations

From the Department of Medicine, Duke University Medical Center, Durham, NC. Dr Sexton is now with the University of Missouri Medical Center, Columbia.

Arch Intern Med. 1977;137(3):362-363. doi:10.1001/archinte.1977.03630150062017

A 51-year-old man with serologically confirmed Rocky Mountain spotted fever was believed to have inappropriate antidiuretic hormone (ADH) secretion. He was observed for four days in the hospital until the correct diagnosis was made. During this period, he progressively became more hyponatremic, despite a low BUN level and the administration of large amounts of sodium and water. At the time, his serum sodium concentration was 117 mEq/liter, and his urine was hypertonic to that of serum. Thereafter, his serum sodium level rose with fluid restriction. Rickettsia-induced CNS damage may have lead to the inappropriate ADH release that was observed in this patient.

(Arch Intern Med 137:362-363, 1977)

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