All issues > Volume 34(3); 1991

Original Article

J Korean Pediatr Soc. 1991;34(3):323-333. Published online March 31, 1991.

Altered secretion of arginine vasopressin in children with CNS diseases.

Kun Whe Kim¹, Eun Sook Kim¹, Cheol Woo Ko¹, Ja Hoon Koo¹, Doo Hong Ahn¹, Won Jung Lee²

¹Department of Pediatrics, School of Medicine Kyungpook National University, Taegu, Korea
²Department of Physiology, School of Medicine Kyungpook National University, Taegu, Korea

Received: January 23, 1991;  Accepted: February 20, 1991.

Abstract

A prospective study was conducted to see the pattern and mechanism of arginine vasopressin (AVP) secretion in children with CNS diseases. Study population consisted of 21 cases with aseptic meningi- tis (meningitis group) and another 21 cases with viral encephalitis or encephalopathy (encephalitis group), who had been admitted to our Pediatric Department during 10 months’ period from April 1985 to January 1986. Seventeen healthy children were used as control. The following results were obtained; On the admission day, serum osmolality showed no difference between study groups and control (meningitis group, 280.5±8.3 and encephalitis group, 281.4±18.4 versus control, 283.7±5.9mOm/ kg). Plasma aldosterone showed elevated level in encephalitis group (81.1 ±82.4) compared with control (16.4±17.7 ng/dl). Plasma cortisol in menigitis group (19.0±10.5) and encephalitis group (33. 9±23.6) were both elevated compared with the control (10.3±3.6 ug/dl), and these values returned to normal range during subsequeunt hospital days. Plasma AVP, AVP/Na ratio and AVP/osmolarity ratio on the admission day also showed elevated values in both meningitis (14.2±9.0 pg/ml, 101.5±63.7 and 48.6±29.0) and encephalitis group (20. l±11.8pg/ml, 142.5±81.3 and 70.9±40.7) compared with control (9.1 ±3.2 pg/ml, 63.3±21.8 and 31.9±10.7). And the values returned to normal range during subsequent hospital days. Plasma AVP values according to the concentration of serum sodium and osmolarity revealed that in about half of the study population elevated level of plasma AVP was noted. Though in the majority of cases, during the subsequent hospital days, these values returned to normal, elevated level persisted in some. The relationship between plasma aldosterone, cortisol and AVP according to the presence of dehydration on the admission day revealed that; 1) aldosterone was increased in encephalitis group with dehydration. However, plasma AVP was increased also in both meiningitis and encephalitis group without dehydration. 2) Cortisol was increased in meningitis group without dehydration and encephalitis group with dehydration. However, plasma AVP was also increased in encephalitis group without dehydration. In summary, it can be concluded from the present stduy that during the early phase of CNS diseases, the secretion of AVP is increased, and in some cases increased secretion persisits for 7 days or longer. And the mechanism of altered secretion of AVP seems to come from the stimulus to the supraoptico- hypophyseal system from the inflammatory process of the CNS disease.

Keywords :arginine vasopressin;CNS diseases