Reset Osmostat in a Healthy Patient
Authors: Joshua H. Lipschutz
Journal: Annals of Internal Medicine (1994)

Brief Reports1 April 1994Reset Osmostat in a Healthy PatientJoshua H. Lipschutz, MD and Allen I. Arieff, MDJoshua H. Lipschutz, MDFrom the Veterans Administration Medical Center, University of California at San Francisco, San Francisco, California.Search for more papers by this author and Allen I. Arieff, MDFrom the Veterans Administration Medical Center, University of California at San Francisco, San Francisco, California.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-120-7-199404010-00007 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Reset osmostat is a rare condition in acutely ill patients with severe pulmonary [1, 2], neurologic [3, 4], or malignant processes [5]. When hyponatremia occurs because of “reset osmostat,” renal concentrating and diluting capacities are normal but the regulation of arginine vasopressin to maintain serum tonicity takes place at a lower osmolal threshold.We report chronic stable hyponatremia secondary to reset osmostat in a healthy middle-aged man who had sustained a grenade explosion to his face 41 years earlier.Case ReportThe 60-year-old man was generally healthy, had an advanced engineering degree, and was a full-time supervisor until he recently ...References1. DeFronzo RA, Goldberg M, Agus ZS. Normal diluting capacity in hyponatremic patients. Reset osmostat or a variant of the syndrome of inappropriate antidiuretic hormone secretion. Ann Intern Med. 1976; 84:538-42. Google Scholar2. Hill AR, Uribarri J, Mann J, Berl T. Altered water metabolism in tuberculosis: Role of vasopressin. Am J Med. 1990; 88:357-64. Google Scholar3. Bannister P, Sheridan P, Penney MD. Chronic reset osmoreceptor response, agenesis of the corpus callosum, and hypothalamic cyst. J Pediatr. 1984; 104:97-9. Google Scholar4. Howe JG, Penney MD, Currie S, Morgan D. Thirst, resetting of the osmostat, and water intoxication following encephalitis. Ann Neurol. 1983; 13:201-4. Google Scholar5. Wall BM, Crofton JT, Share L, Cooke CR. Chronic hyponatremia due to resetting of the osmostat in a patient with gastric carcinoma. Am J Med. 1992; 93:223-8. Google Scholar6. Robertson GL, Berl T. Pathophysiology of water metabolism. In: Brenner BM, Rector FC, eds. The Kidney. 4th ed. Philadelphia: W.B. Saunders Co.; 1991:710-6. Google Scholar7. Cooper PE. Disorders of the hypothalamus and pituitary gland. In: Joynt RJ, ed. Clinical Neurology. v. 3. c. 36. Philadelphia: J.B. Lippincott Co.; 1991:50-61. Google Scholar8. Assadi FK, Agrawal R, Jocher C, John EG, Rosenthal IM. Hyponatremia secondary to reset osmostat. J Pediatr. 1986; 108:2: 262-4. Google Scholar9. Rowe JW, Shock NW, DeFronzo RA. The influence of age on the renal response to water deprivation in man. Nephron. 1976; 17: 270-8. Google Scholar10. Cooke CR, Turin MD, Walker WG. The syndrome of inappropriate antidiuretic hormone secretion (SIADH): pathophysiologic mechanisms in solute and volume regulation. Medicine. 1979; 58:240-51. Google Scholar Author, Article, and Disclosure InformationAffiliations: From the Veterans Administration Medical Center, University of California at San Francisco, San Francisco, California.Corresponding Author: Joshua H. Lipschutz, MD, Division of Nephrology, University of California, San Francisco, Box 0532, Room 1065 HSE, San Francisco, CA 94121.Acknowledgment: The authors thank Dr. David Lovett for referring this patient and Jenifer Schaten for assisting in manuscript preparation.Grant Support: In part by the research service of the Veterans Administration Medical Center, San Francisco, California; grant RO1AG08575 from the National Institute of Aging; and Academic Nephrology Training grant DK07219 from the Academic Nephrology Training Program from the National Institute of Diabetes and Digestive and Kidney Disease, Bethesda, Maryland. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByReset Osmostat: The Result of Chronic Desmopressin Abuse?Therapeutic Approach to Electrolyte EmergenciesWater balance in rheumatoid arthritis: replyNeurogene St�rung der OsmoregulationHyponatremia in the Psychiatric Patient: A Review of Diagnostic and Management StrategiesHyponatremia Secondary to Reset Osmostat in a Child with a Central Nervous System Midline Defect and a Chromosomal AbnormalityFrom plasma [Na + ] to diagnosis and treatment 1 April 1994Volume 120, Issue 7Page: 574-576KeywordsArginineBlood plasmaCellsCreatinineHyponatremiaHypothalamusProteinsSodiumUrineVasopressin Issue Published: 1 April 1994 CopyrightCopyright © 1994 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...