Adipsic hypernatremia in two sisters
Article Abstract:
Adipsic hypernatremia (lack of thirst accompanied by high blood levels of sodium) is a rare illness in which regulation of salt balance and thirst are disrupted, usually due to a lesion in the hypothalamus or other brain centers. This article describes adipsic hypernatremia in two sisters, only one of whom had a hypothalamic lesion. The older sister had normal levels of salts when she was hospitalized for meningitis at the age of three months. Two months later, she began drinking very little, and she was then hospitalized at the age of 10 months due to failure to thrive. Sodium levels and osmolality (amount of dissolved salts) of blood but not urine, were elevated. These normalized when the patient was given intravenous fluids, but increased again when fluids were stopped; the patient showed no signs of thirst. Studies of hypothalamic hormones and imaging of brain structures were normal, except that vasopressin, a hypothalamic hormone secreted in response to thirst and elevated osmolality, was present in low levels and did not rise or fall in response to various stimuli. The patient was treated with synthetic vasopressin and forced fluids, and subsequently gained weight. Minor illnesses led to dehydration and hospitalization, however. The second sister was born with microcephaly (small head size) and cleft lip and palate, and was hospitalized at the age of four months for seizures. Blood sodium levels and osmolality were elevated and she, like her sister, showed no signs of thirst. Electroencephalography and brain imaging showed abnormalities. Besides a vasopressin abnormality similar to her sister's, this patient also had abnormal thyroid hormone responses, suggestive of hypothalamic dysfunction. She was treated with synthetic vasopressin and forced hydration, achieving appropriate growth, but became dehydrated with minor illnesses. Unlike her sister, the patient was severely mentally retarded. This article describes the most severe manifestation of adipsic hypernatremia, and is the first report of the disease occurring twice within a family; a maternal aunt who died at three months of age possibly had the same disease. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Diseases of Children
Subject: Health
ISSN: 0002-922X
Year: 1991
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The hollow man: one of the worst things about Vietnam is that it killed even those who survived
Article Abstract:
A Vietnam veteran relates how his memory and reality of that war are blurred so that he has no truth. He knows only that he is an empty man, and a man under the burden of memory. He will spend his life trying to find that which he lost when he went to war.
Publication Name: The New York Times Magazine
Subject:
ISSN: 0028-7822
Year: 1996
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Yes, I'm gay
Article Abstract:
Twenty-eight year-old Florence Finkle, a Manhattan lawyer, describes how her coming out as a lesbian has finally enabled her to engage in physical and emotional intimacy. She has learned to love being herself by talking openly about her sexuality.
Publication Name: Glamour
Subject: Health
ISSN: 0017-0747
Year: 1998
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