Antidiuretic Principle in Tuberculous Lung Tissue of a Patient with Pulmonary Tuberculosis and Hyponatremia

Abstract

A 51-year-old white man had advanced pulmonary tuberculosis without renal or adrenal involvement, hyponatremia, and high urinary osmolality. The tuberculous lung tissue and the urine from the patient contained antidiuretic activity (assayed in rats undergoing water-ethanol diuresis) equivalent to 22 ±8 µunits/mg tissue powder and 57 ±8 µunits/ml of arginine vasopressin, respectively, and the patient's plasma did not contain detectable antidiuretic activity. It is indicated that the antidiuretic principle is either very similar or identical to arginine vasopressin. Uninvolved lung tissue from the patient, suspension of Mycobacterium tuberculosis, or culture media containing metabolites of M. tuberculosis did not have antidiuretic properties. Tuberculous lung tissue may either produce antidiuretic hormone or adsorb an inappropriately released hormone from the posterior pituitary. This is the first demonstration of a relation between antidiuretic hormone and hyponatremia in a patient with pulmonary tuberculosis.