pituitrin and Tuberculosis--Pulmonary

Pneumonia is one of the most serious infections in the neonate and is responsible for a large percentage of neonatal mortality. Pneumonia in a premature or term infant who is debilitated by an underlying problem such as hyaline membrane disease carries an extremely high morbidity and mortality. Since most of the bacterial pneumonias are treatable, early recognition and diagnosis and vigorous treatment are essential. X-ray findings, though helpful, serve only as a guideline. Prognosis is adversely affected if pneumonia results in generalized sepsis, leading to meningitis, disseminated intravascular coagulation, and osteomyelitis. Prompt antibiotic treatment should be begun before the etiologic agent or drug susceptibility is known.

Topics: Acute Disease; Ampicillin; Bacterial Infections; Gentamicins; Humans; Infant, Newborn; Infant, Newborn, Diseases; Kanamycin; Penicillins; Pneumonia; Pneumonia, Aspiration; Pneumonia, Viral; Syphilis, Congenital; Tuberculosis, Pulmonary; Vasopressins

Hyponatremia is among the most common biochemical abnormalities in hospital inpatients. The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is one of several causes of hyponatremia, particularly in patients with pulmonary diseases. The mechanism of SIADH associated with pulmonary infection is, however, poorly understood. We report an unusual case of hyponatremia in a man with pulmonary TB and central diabetes insipidus with biochemical evidence of ectopic antidiuretic hormone production as a possible mechanism causing hyponatremia.

Topics: Antidiuretic Agents; Deamino Arginine Vasopressin; Follow-Up Studies; Humans; Hyponatremia; Male; Middle Aged; Sodium; Tuberculosis, Pulmonary; Vasopressins

We report a pregnant woman presenting with seizure secondary to hyponatremia by inappropriate antidiuretic hormone secretion. Aetiology was unknown urinary and lung tuberculosis. This case report presents diagnosis strategy of inappropriate antidiuretic hormone secretion and the arguments for its aetiology.

Topics: Adult; Female; Humans; Hyponatremia; Pregnancy; Pregnancy Complications; Seizures; Tuberculosis, Pulmonary; Tuberculosis, Urogenital; Vasopressins

Topics: Body Water; Humans; Hyponatremia; Tuberculosis, Pulmonary; Vasopressins

Patients with hyponatremia due to tuberculosis have shown variable responses to water loading in previous small studies, ranging from persistent antidiuresis to a normal diuresis. Although tuberculosis is considered a cause of the syndrome of inappropriate antidiuretic hormone secretion (SIADH), circulating vasopressin has been documented in only a few cases. We studied a larger group of patients to determine whether it can be suppressed by a short-term reduction in osmolality.. Twenty-eight hyponatremic patients (mean age +/- SD: 40 +/- 10 years) with pulmonary or miliary tuberculosis underwent a clinical evaluation, measurement of blood and urine chemistry values, and (in 22) a water load of 20 mL/kg. Volume status was evaluated by urine sodium concentration, blood and urine urea nitrogen, and plasma renin activity. Endocrine, renal, and other recognized causes of SIADH were excluded.. All 22 patients exhibited a decline in urine osmolality and an increase in free water clearance after water loading. Water excretion was fully normal in seven of 22, with the remainder showing variable impairment of diluting ability and/or volume excreted. Plasma vasopressin, measured in 11 of 22 patients as well as in six others not subjected to water loading, was detectable despite hypo-osmolality in 16 of 17. Vasopressin levels declined after water loading, from 1.85 +/- 1.32 to 0.77 +/- 0.25 pg/mL (p less than 0.05). The majority of patients had the euthyroid sick syndrome but normal adrenal responses to cosyntropin. Although several patients had mild volume depletion when studied, this factor did not appear to explain the defect in water excretion. Hyponatremia resolved predictably within days to weeks of antituberculous therapy.. Circulating vasopressin remains detectable in hyponatremic patients with tuberculosis and is responsive to changes in osmolality. A downsetting of osmoregulation induced by active tuberculosis ("reset osmostat") could explain this abnormality, but we cannot exclude an unidentified non-osmotic stimulus that can be counteracted by water loading.

Topics: Adult; Hemodynamics; Humans; Hyponatremia; Osmolar Concentration; Thyroid Function Tests; Tuberculosis, Miliary; Tuberculosis, Pulmonary; Vasopressins; Water

Topics: Humans; Inappropriate ADH Syndrome; Tuberculosis, Pulmonary; Vasopressins

Bilateral tuberculous pneumonia with the syndrome of inappropriate secretion of antidiuretic hormone was the cause of the adult respiratory distress syndrome in an elderly patient. Early recognition and prompt therapy enabled the patient to make a complete recovery without the necessity for mechanical ventilation. With the shift of care of tuberculous patients out of the sanitorium, the practicing physician should be aware of the varied manifestations of tuberculosis.

Topics: Aged; Blood Urea Nitrogen; Electrolytes; Humans; Male; Oxygen Inhalation Therapy; Pulmonary Fibrosis; Radiography; Respiratory Distress Syndrome; Tuberculosis, Pulmonary; Vasopressins

Four patients with chronic illnesses and stable hyponatremia and plasma hypotonicity had normal urinary diluting capacity, with excretion of greater than 80% of a standard water load (20 ml/kg) within 4 hours and maintenance of a urine osmolality less than 100 mosmol/kg, during sustained water diuresis. Administration of a chronic salt load did not correct the hyponatremia. However, it was stabilized after treatment of the underlying medical condition. These subjects may represent a true resetting of the osmostat or a variant of the syndrome of inappropriate antidiuretic hormone secretion.

Topics: Aged; Alcoholism; Diagnosis, Differential; Female; Humans; Hyponatremia; Kidney; Kidney Concentrating Ability; Male; Middle Aged; Osmolar Concentration; Tuberculosis, Pulmonary; Vasopressins; Water-Electrolyte Balance

Topics: Adult; Hormones, Ectopic; Humans; Hyponatremia; Male; Syndrome; Tuberculosis, Pulmonary; Vasopressins

Topics: Hormones, Ectopic; Humans; Hyponatremia; Liver Cirrhosis; Male; Middle Aged; Tuberculosis, Meningeal; Tuberculosis, Pulmonary; Vasopressins

Topics: Aged; Aspergillosis; Female; Humans; Hyponatremia; Lung Diseases; Lung Diseases, Fungal; Male; Middle Aged; Tuberculosis, Pulmonary; Vasopressins

Topics: Biological Assay; Hormones, Ectopic; Humans; Hyponatremia; Lung; Male; Middle Aged; Pituitary Gland, Posterior; Tuberculosis, Pulmonary; Vasopressins

Topics: Acute Disease; Humans; Hyponatremia; Infusions, Parenteral; Male; Middle Aged; Tuberculosis, Miliary; Tuberculosis, Pulmonary; Vasopressins; Water-Electrolyte Balance

Topics: Adult; Aged; Humans; Hyponatremia; Male; Pituitary Gland, Posterior; Tuberculosis, Pulmonary; Vasopressins

Topics: Adult; Alcoholism; Cortisone; Creatinine; Deficiency Diseases; Ethanol; Humans; Hyponatremia; Male; Middle Aged; Potassium; Sodium; Tuberculosis, Pulmonary; Vasopressins; Water

Topics: Aged; Bronchopneumonia; Humans; Hyponatremia; Male; Tuberculosis, Pulmonary; Vasopressins

Topics: Adrenal Cortex Hormones; Aerosols; Anesthetics, Local; Anti-Bacterial Agents; Antitubercular Agents; Asthma; Bronchitis; Bronchodilator Agents; Catalogs, Drug as Topic; Cresols; Detergents; Drug Prescriptions; Ephedrine; Epinephrine; Germany, East; Humans; Isoproterenol; Mineral Waters; Papaverine; Parasympatholytics; Respiratory Therapy; Respiratory Tract Diseases; Solvents; Sympathomimetics; Terpenes; Theophylline; Tuberculosis, Pulmonary; Vasopressins

Topics: Adult; Humans; Hyponatremia; Male; Middle Aged; Tuberculosis, Pulmonary; Vasopressins; Water-Electrolyte Balance

Topics: Ascites; Biomedical Research; Blood Gas Analysis; Blood Pressure; Bronchiectasis; Cardiovascular System; Heart; Oxytocin; Peptides; Pharmacology; Pulmonary Circulation; Pulmonary Emphysema; Pulmonary Fibrosis; Pulse; Respiration; Tuberculosis; Tuberculosis, Pulmonary; Vasopressins

Topics: Blood Coagulation; Bronchiectasis; Bronchitis; Capillary Permeability; Diagnosis, Differential; Hemoptysis; Humans; Lung Neoplasms; Menstrual Hygiene Products; Pathology; Pharmacology; Pituitary Hormones, Posterior; Sympathomimetics; Tampons, Surgical; Tracheitis; Tuberculosis; Tuberculosis, Pulmonary; Vasopressins

Topics: Blood Circulation; Blood Gas Analysis; Blood Pressure; Cardiac Catheterization; Cardiovascular System; Felypressin; Heart Function Tests; Injections, Subcutaneous; Pharmacology; Pulmonary Artery; Tuberculosis; Tuberculosis, Pulmonary; Vasopressins