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Hypersecretion of Arginine Vasopressin in Acromegaly

Department of Medicine, Peter Bent Brigham Hospital, and Harvard Medical School Boston, Massachusetts 02115

Four of 5 patients with untreated active acromegaly demonstrated prolonged antidiuresis and sustained release of arginine vasopressin (AVP) with nicotine stimulation of the neurohypophysis. This hyperresponsiveness was acutely suppressed by adrenal steroids in 2 subjects. Long-term estrogen treatment restored a normal nicotine response in one patient; another showed improved nicotine response after pituitary X-ray irradiation and a normal response with added estrogen therapy. Three additional active patients in clinical remission with estrogen medication showed normal responses to nicotine. These studies suggest that, in active acromegaly, there is a neurohypophyseal hyperresponsiveness to nicotine which improves with clinical remission of the disease. Since the osmoregulatory responses of the neurohypophysis to dehydration, hemodilution and induced hyperosmolality fell within the expected normal range, it appears to be a selective neurohypophyseal derangement.

Supported by grants from the USPHS (HD 03006) and the William F. Milton Fund of Harvard University. Clinical studies were performed on the Clinical Center of the Peter Bent Brigham Hospital, supported by Grant FR-00031 from the USPHS.

¹ This work was done in part during the tenure of a fellowship from the Medical Research Council of Canada.

Present address: Centre Hospitalier Universitaire, Sherbrooke, P. Q., Canada.

² Supported by a Lederle International Fellowship.

³ Address reprint requests to J. F. Dingman, M.D., Peter Bent Brigham Hospital, 721 Huntington Ave., Boston, Mass. 02115.

Received March 27, 1969.