pituitrin and Adenoviridae-Infections

Four children aged between 7 and 19 months with severe bronchopneumonia due to adenovirus type 7, proved by virology and/or serology developed severe hyponatraemia. One of them is reported in detail: it was possible to estimate plasma ADH levels and thereby prove the existence of reversible hypersecretion of the hormone. Whilst the syndrome of hyponatraemia with inappropriate secretion of ADH has not yet been reported in association with severe pneumonia in the child, it is known in adults. The limits of the syndrome and its physiopathology are discussed. It may be due either to vagal stimulation as a result of a fall in left aressure, or to central involvement. Therapeutic implications of the problem are emphasized.

Topics: Adenoviridae Infections; Adenovirus Infections, Human; Diuresis; Hormones, Ectopic; Humans; Hyponatremia; Hypothalamo-Hypophyseal System; Infant; Lung; Male; Pituitary Gland, Posterior; Vagus Nerve; Vasopressins

Metabolic abnormalities compatible with inappropriate secretion of ADH developed during the course of severe viral pneumonia in a 17-year-old Navy recruit. With a regimen of strict fluid restriction, normalization of these abnormalities occurred. Marked leukopenia and hypoxia were also present, but gradually improved with resolution of the pneumonia. Inappropriate ADH secretion has been associated most often with bacterial pneumonia and this patient represents one of the few with viral pneumonia complicated by this syndrome. While the previous cases were assoicated with influenza virus, this patient was infected with adenovirus-7 which is endemic in the military recruit population.

Topics: Adenoviridae; Adenoviridae Infections; Adolescent; Hormones, Ectopic; Humans; Hyponatremia; Male; Pneumonia, Viral; Vasopressins; Water-Electrolyte Imbalance