title: Reset osmostat in pregnancy: a case report.
abstract: The reset osmostat syndrome, a form of inappropriate antidiuretic hormone secretion (SIADH), occurs when the threshold for antidiuretic hormone secretion is moved downward. There is evidence to suggest a "reset osmostat phenomenon" in normal pregnancies, whereby the average plasma-osmolality is decreased by 5-10 mOsm/kg. We present a case of a non-physiologic reset osmostat in a pregnant patient, thought to be caused by large intracranial arteriovenous malformations and intraventricular hemorrhage. The presence of a reset osmostat should be suspected in any patient with apparent SIADH who has mild hyponatremia that is stable over many days despite variations in sodium and water intake. Therapeutic efforts to raise the serum sodium concentration appear to be unnecessary.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Hofstra North Shore-LIJ School of Medicine , Hempstead, NY , USA .
authors.forename: Kemoy
authors.initials: K
authors.lastname: Harris
authors.forename: Ravi
authors.initials: R
authors.lastname: Shankar
authors.forename: Karen
authors.initials: K
authors.lastname: Black
authors.forename: Burton
authors.initials: B
authors.lastname: Rochelson
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D001164:Arteriovenous Fistula / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D002543:Cerebral Hemorrhage / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D005260:Female; D006801:Humans; D007177:Inappropriate ADH Syndrome / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology*; D007231:Infant, Newborn; D002538:Intracranial Arteriovenous Malformations / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D000305:Adrenal Cortex Hormones