GIDROPEKSICHESKY SYNDROME

From Big Medical Encyclopedia

GIDROPEKSICHESKY SYNDROME (grech, hydor water + pexis break-in, consolidation, condensation; synonym: not sugar anti-diabetes, Parkhon's syndrome, primary adiuretizm, syndrome of idiopathic hypostases, gipergidropeksichesky syndrome) — the clinical syndrome which is characterized by reduction of amount of urine, lack of thirst and developing of the hypostases which are not connected with pathology of heart, kidneys and a liver. In G.'s symptomatology of page there is also a number of the signs characteristic of defeat of a hypothalamus: tendency to obesity, disturbance of secretion of gonadotropic hormones of a hypophysis, emotional and vegetovascular disturbances; existence of an endokranioz (a thickening of an internal plate of a frontal bone) is frequent.

From of page women at the age of 30 — 60 years suffer generally, it is rare — men.

K. Parkhon for the first time described of page (1933).

Etiology it is not established. Of page is considered as «a syndrome of idiopathic hypostases». Flu, neuroinfections, pregnancy and childbirth can precede a disease; cases of development of G. of page after removal of a uterus and ovaries are known. But the mental injury is more frequent reason of G. of page.

Pathogeny it is connected with hypersecretion of antidiuretic hormone, disturbances of secretion of Aldosteronum, ovarian and thyroid hormones, catecholamines and disturbance of vascular permeability.

It is necessary to emphasize orthostatic character of a delay of liquid: the mocheotdeleniye decreases during walking, at physical. an overstrain also increases after long stay in horizontal position (after a night dream, rest), reducing puffiness. It demonstrates participation of Aldosteronum in the mechanism of formation of hypostases. At increase in secretion of Aldosteronum release of sodium with urine decreases, the content of potassium in blood is usually normal. At the increased release of antidiuretic hormone loss of sodium is considerable (Hyponatremia); besides, concentration function of kidneys increases, there can be some angiotonic reactions (tranzitorny arterial hypertension, a spasm of arterioles of a retina of an eye, etc.).

A clinical picture

there are face edemas, extremities, a trunk. Usually peripheral hypostases are moderately expressed, but the delay of liquid in an organism promotes bystry increase of weight and emergence of symptoms of water intoxication: headaches, sleep disorder, joint pains and adynamia; hypostases can be constant and incidental. The periods of the reduced mocheotdeleniye are replaced by a spontaneous diuresis; the liquid watery chair is sometimes observed. At women at whom note instability of pulse and the ABP, numbness of extremities, a sonitus, passing losses of a voice and sight, dyskinesia of bilious ways, decrease in tolerance to glucose. Content of antidiuretic hormone in blood and Aldosteronum in blood and urine at one patients is increased, at others — is normal. Level of cholesterol in blood increases. At the reduced mocheotdeleniye the specific weight of urine high. Test the Osage apple — Aldrich is accelerated (see. Mac-Klyura-Oldricha test ), and administration of liquid in number of 1 l leads to an ischuria during the 5th hour.

A number of patients can have signs of a hypothyroidism. Reduction of absorption 131 The I thyroid gland explain with the influence of antidiuretic hormone reducing functional activity of a thyroid gland.

As option G. of page it is possible to consider cyclic, premenstrual hypostases.

Treatment

the Specific means suppressing products of antidiuretic hormone suitable for a wedge, uses, no. Appoint Spironolactonum (a synonym: veroshpiron, Aldactonum) who is an antagonist of Aldosteronum, on 100 — 300 mg a day constantly or periodically, in hard cases — for life. At the same time enter diuretic which should be alternated since to them in the course of treatment there is a refrakternost. Eliminate with introduction of Spironolactonum or warn the hypopotassemia arising at systematic reception of diuretics, improve water exchange and the general state.

There are observations of successful use of a roentgenotherapy on interstitial and pituitary area in a dose of 400 — 600 rubles.

It is shown a dignity. - hens. treatment in Truskavets in connection with diuretic effect of mineral waters of the resort.

Forecast for life favorable. Working ability of patients, as a rule, decreases in process of G.'s development by page.


Bibliography: Gordon I. B., Don L. V. and Stepanova M. P. To a question of a pathogeny of a gipergidropeksichesky syndrome, Rubbed. arkh., t. 43, No. 2, page 107, 1971; Ross E. Zh. Aldosteronum in clinical and experimental medicine, the lane with English, page 108, L., 1962; With h and-v of £ t J. a. H about 1 e e k V. Studies on antidiuretic hormone, Acta med. Acad. Sci. hung., v. 23, p. 81, 1966; P a r h o n C. I. Sur le syndrome hyperhydropexique (hy-perr^tro-hypophysaire), Bull. Soc. Med. Paris, t. 49, p. 768, 1933; Teodosi-ev L. S. Hiper-and hipoaldosteronizjm, page 71, Plovdiv, 1965, bibliogr.

F. M. Egart.

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