pituitrin and Leukemia--Lymphoid

A rare case of acute lymphoblastic leukemia presenting with vasopressin-responsive diabetes insipidus (DI) is reported. The patient presented with polydypsia and polyuria of 9 L/day. Findings from special investigations of the CNS, including brain scan, computerized tomographic scan, EEG, and lumbar puncture were within normal limits. The patient's condition improved substantially after receiving vasopressin injections and later chlorpropamide. The incidence and underlying mechanism of this rare complication of acute leukemia are reviewed, and the response of DI to chlorpropamide is discussed briefly. In this patient it is presumed that the DI was caused by leukemic infiltration of the supraopticohypophyseal tract, posterior pituitary, or hypothalamus.

Topics: Adult; Chlorpropamide; Diabetes Insipidus; Female; Humans; Leukemia, Lymphoid; Vasopressins

One the basis of two special typical cases, the authors detail the symptoms and signs and consider the physiopathology of inappropriate secretion of antidiuretic hormone related to vincristine. Urinary ADH was measured in both cases. ADH levels could be studied on ten consecutive occasions during the course of one of the cases (obs. n 1). Eleven similar cases have been found in the literature. ADH was measured in only three of them. Methods of treatment are considered, with particular emphasis on the role of demeclocycline.

Topics: Child; Demeclocycline; Humans; Inappropriate ADH Syndrome; Leukemia, Lymphoid; Vasopressins; Vincristine

Topics: Atrophy; Brain; Brain Diseases; Chlorpropamide; Diabetes Insipidus; Female; Humans; Leukemia, Lymphoid; Middle Aged; Pituitary Gland; Vasopressins

The syndrome of inappropriate antidiuretic hormone secretion (SIADH) has been recognized to occur following treatment with vincristine. None of the reports have provided information regarding its potential for recurrence on further challenge with vincristine (VCR), an agent generally required for repeated use in patients with malignancies. Symptomatic hyponatremia and SIADH that occurred 8 days following administration of VCR in a child with acute lymphatic leukemia was documented with specific radioimmunoassay of urinary ADH levels. The further occurrence of recurrent elevations in ADH excretion 8-10 days following repeated treatment with VCR was also observed. However, SIADH was prevented by prophylactic rigorous fluid restriction. The occurrence of SIADH following VCR therefore does not preclude the further safe usage of this drug.

Topics: Child, Preschool; Dexamethasone; Female; Humans; Hyponatremia; Leukemia, Lymphoid; Radiation Effects; Radioimmunoassay; Skull; Vasopressins; Vincristine; Water-Electrolyte Balance

Topics: Adolescent; Adult; Arginine; Blood; Carcinoma, Small Cell; Cyclophosphamide; Humans; Leukemia, Lymphoid; Lung Neoplasms; Male; Middle Aged; Neoplasm Metastasis; Osmolar Concentration; Peripheral Nervous System Diseases; Prednisone; Radioimmunoassay; Sodium; Urine; Vasopressins; Vincristine

Topics: Blood; Child, Preschool; Humans; Hyponatremia; Leukemia, Lymphoid; Male; Osmolar Concentration; Vasopressins; Vincristine; Water Deprivation

Topics: Child; Coma; Epilepsy, Tonic-Clonic; Humans; Hyponatremia; Hypotension; Leukemia, Lymphoid; Male; Reflex, Abnormal; Vasopressins; Vincristine

Topics: Child; Diabetes Insipidus; Humans; Leukemia, Lymphoid; Male; Nicotine; Pituitary Gland, Posterior; Vasopressins