視束上部の奇形腫による中枢性高ナトリウム血症について

Neurogenic Hypernatremia Caused by a Teratoma on the Supraoptic Region

　Allott（1939）^1）は，はじめて，高Na血症，高Cl血症，および，尿中へのK排泄減少を示した症例において胃に異常がなく，これに対し中枢神経系に障害のあるものを観察し，症状が腎の神経性，またはホルモン性調節異常に基因すると推定した．それ以来，種々の脳疾患で高Na血症の報告がみられ，その発生機転が論議されてきた^{7，12，18）}．自験例のうち，高Na血症，高Cl血症が第Ⅲ脳室前部に発生した奇形腫による視床下部破壊に基因すると考えられる症例について報告する．

This is a case report involving a 9 year old girl with a teratoma that invaded mainly the bilateral hypothalamus. The girl was observed for 14 months after partial surgical removal. During that tims she showed aphagia, adipsia, hypopituitarism, and visual and psychiatric disturbances. Severe hypernatremia also was present, even though large amounts of 5% glucose solution without salt were given I. V. Food and water were given by nasal gastric gavage and later gavage via gastric fistula, but the hypernatremia remained unchanged.