Inappropriate Antidiuretic Hormone Secretion

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Abstract
THE SYNDROME of inappropriate antidiuretic hormone (SIADH) secretion is characterized by serum hyponatremia and hyposmolality associated with relative urinary hyperosmolality and excessive renal salt loss; there is an absence of clinical evidence of fluid volume depletion, and renal and adrenal function are normal.1 The subject of this report, a child with a hypothalamic glioma, fulfilled all of these criteria and, in addition, showed several atypical features of the SIADH. These included a normal response to an acute water load, the occasional failure to respond to severe water restriction, and the discontinuous secretion of a measurably elevated ADH co-existing with persistent hyponatremia. These features are not inconsistent with the inappropriate secretion of ADH. A possible alternative explanation is that a malfunctioning hypothalamic "osmostat" may be an associated defect. Report of a Case This 6-year-old boy was hospitalized on Oct 19, 1968, because of headaches and vomiting of several