title: Depletion of neurohypophyseal content of vasopressin in septic shock.
abstract: OBJECTIVE
  To assess the mechanisms underlying the inappropriately low plasma vasopressin levels reported in septic shock.
  
  
  METHODS
  Prospective case series.
  
  
  METHODS
  A 26-bed general medical intensive care unit at a university hospital.
  
  
  METHODS
  Septic shock patients.
  
  
  RESULTS
  In three consecutive patients with septic shock, plasma vasopressin levels, circulating vasopressinase activity, baroreflex sensitivity, and neurohypophyseal vasopressin content were assessed. Plasma vasopressin concentration was unexpectedly within normal range in two patients (1.6 pg/mL and 1.8 pg/mL) and increased in one (16 pg/mL). In all cases, vasopressinase activity was undetectable, baroreflex sensitivity was decreased, and the high signal intensity of the posterior lobe of the pituitary gland on T1-weighted magnetic resonance images was absent. Magnetic resonance imaging and plasma vasopressin levels normalized after recovery from shock in the patient who survived.
  
  
  CONCLUSIONS
  These data suggest that in septic shock, inappropriately low plasma levels of vasopressin are at least partly related to a depletion of vasopressin stores in the neurohypophysis.
authors: Service de Réanimation Médicale, Hôpital Raymond Poincaré, Garches, France.
authors: Tarek
authors: T
authors: Sharshar
authors: Robert
authors: R
authors: Carlier
authors: Anne
authors: A
authors: Blanchard
authors: Antoine
authors: A
authors: Feydy
authors: Françoise
authors: F
authors: Gray
authors: Michel
authors: M
authors: Paillard
authors: Jean-Claude
authors: JC
authors: Raphael
authors: Philippe
authors: P
authors: Gajdos
authors: Djillaii
authors: D
authors: Annane
mesh_terms: D000368:Aged; D017704:Baroreflex; D010122:Cystinyl Aminopeptidase / Q000097:blood; D005583:Fourier Analysis; D005738:Gas Gangrene / Q000378:metabolism / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010904:Pituitary Gland, Posterior / Q000378:metabolism* / Q000473:pathology; D011014:Pneumonia / Q000378:metabolism / Q000503:physiopathology; D011446:Prospective Studies; D012772:Shock, Septic / Q000378:metabolism* / Q000503:physiopathology; D018461:Soft Tissue Infections / Q000378:metabolism / Q000503:physiopathology; D018709:Statistics, Nonparametric; D014667:Vasopressins / Q000378:metabolism*
chemical_list: D014667:Vasopressins; D010122:Cystinyl Aminopeptidase