Journal
NEW ENGLAND JOURNAL OF MEDICINE
Volume 352, Issue 18, Pages 1884-1890Publisher
MASSACHUSETTS MEDICAL SOC
DOI: 10.1056/NEJMoa042743
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Funding
- NCRR NIH HHS [M01RR01271, M01 RR001271] Funding Source: Medline
- NIDDK NIH HHS [T32DK07161, T32 DK007161] Funding Source: Medline
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The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is a common cause of hyponatremia. We describe two infants whose clinical and laboratory evaluations were consistent with the presence of SIADH, yet who had undetectable arginine vasopressin (AVP) levels. We hypothesized that they had gain-of-function mutations in the V2 vasopressin receptor (V2R). DNA sequencing of each patient's V2R gene (AVPR2) identified missense mutations in both, with resultant changes in codon 137 from arginine to cysteine or leucine. These novel mutations cause constitutive activation of the receptor and are the likely cause of the patients' SIADH-like clinical picture, which we have termed ``nephrogenic syndrome of inappropriate antidiuresis.''
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