Thirst, resetting of the osmostat, and water intoxication following encephalitis
Corresponding Author
J. G. Howe MRCP
Department of Medicine, St. James's University Hospital, Leeds, England
Department of Medicine, St. James's University Hospital, Beckett Street, Leeds LS9 7TF, United KingdomSearch for more papers by this authorM. D. Penney MRCPath
Department of Chemical Pathology, The General Infirmary at Leeds, Leeds, England
Search for more papers by this authorS. Currie MD
Department of Neurology, St. James's University Hospital, Leeds, England
Search for more papers by this authorD. Morgan MD
Department of Chemical Pathology, The General Infirmary at Leeds, Leeds, England
Search for more papers by this authorCorresponding Author
J. G. Howe MRCP
Department of Medicine, St. James's University Hospital, Leeds, England
Department of Medicine, St. James's University Hospital, Beckett Street, Leeds LS9 7TF, United KingdomSearch for more papers by this authorM. D. Penney MRCPath
Department of Chemical Pathology, The General Infirmary at Leeds, Leeds, England
Search for more papers by this authorS. Currie MD
Department of Neurology, St. James's University Hospital, Leeds, England
Search for more papers by this authorD. Morgan MD
Department of Chemical Pathology, The General Infirmary at Leeds, Leeds, England
Search for more papers by this authorAbstract
A young man developed pathological thirst and hyperdipsia, hyperphagia, disordered temperature regulation, a lowered threshold for aggressive behavior, apathy, impaired memory, and seizures following encephalitis. He had marked hyponatremia. Bouts of water drinking produced water intoxication and precipitated status epilepticus. Studies of water handling with measurements of plasma osmolality and arginine vasopressin (AVP) revealed a very low thirst threshold (below 242 mOsm/kg) with resetting of the osmostat to a new level (255 mOsm/kg) but normal control of plasma osmolality at that level with adequate AVP release.
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