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Neurohypophyseal Function in Postpartum Hypopituitarism: Impaired Plasma Vasopressin Response to Osmotic Stimuli^*

First Department of Internal Medicine, Nagoya University School of Medicine (Y.I., Y.O., K. Y., K.T.), Japanese Red Cross Nagoya First Hospital (K.K., H.H.), Japanese Red Cross Nagoya Second Hospital (T.I.), Nagoya National Hospital (M.N.) Nagoya 466, Japan
the Central Laboratory for Clinical Investigation, Aichi Medical University (A.T.) Aichi 480-11, Japan

Address all correspondence and requests for reprints to: Yasumasa Iwasaki, M.D., First Department of Internal Medicine, Nagoya University School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466, Japan.

We studied neurohypophyseal function in 12 women with postpartum hypopituitarism (Sheehan’s syndrome) by measuring plasma arginine vasopressin concentrations during 5% hypertonic saline infusions. All patients had a history of obstetric shock or massive bleeding, and were receiving cortisol and/or L-T₄ replacement therapy. None had any symptoms of diabetes insipidus. The mean basal plasma vasopressin level in the patients [0.6 ± 0.1 (±SE) pmol/L] was significantly lower (P < 0.01) than that in normal adults (2.5 ± 0.5 pmol/L; n = 12), whereas mean plasma osmolality values were similar in the two groups. During hypertonic saline infusion, the 10 hypopituitary patients had varying degrees of subnormal arginine vasopressin responses to the increase in plasma osmolality. Urine-concentrating ability after dehydration also was lower in the patients, although overt polyuria was absent at the time of this study. These results indicate that the osmoregulation of arginine vasopressin secretion is frequently impaired in postpartum hypopituitarism, suggesting neurohypophyseal damage.

^* This work was supported in part by a Research Grant for Intractable Diseases from the Ministry of Health and Welfare, Japan.

Received April 26, 1988.

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