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By Tony Hyland

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It acts by enhancing the peripheral antidiuretic action of vasopressin, but should b e used with caution because it may cause profound hypoglycaemia. Clofibrate may reduce urine volume by 50% in patients with partial diabetes insipidus. However, it is generally less effective than chlorpropamide and is associated with a number of significant side-effects. Carbamazepine, in contrast to the two former drugs, is thought to act by stimulating the neurohypophyseal secretion of vasopressin. It has no intrinsic antidiuretic activity itself, and does not enhance effects of vasopressin in animals.

Many patients who have mild degrees of coeliac disease may present solely with short stature and very little evidence of malnutrition or gastrointestinal disease. Furthermore, there may not b e an obvious positive family history. Since its prevalence in England is considered to b e between 1/2000 and 1/3000 of the population, it is a relatively common disease. Diagnosis can readily and simply b e excluded by a jejunal biopsy. The releasing factor for growth hormone, first identified from a human pancreatic tumour, and related peptides are now becoming available to test growth hormone release from the pituitary.

Serum total thyroxine was 84 mmol/1. He had a standard water load test (20 ml/kg), the results of which are given in Figure 12a. Vasopressin was also measured during 46 25 Plasma vasopressin (pmol/1) 20 15 10 :-Normal!

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Patterns in Nature by Tony Hyland

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