Session: SUN 130-162-Neuroendocrinology
Poster Board SUN-162
Methods: We measured CT-ProVasopressin and sodium levels in a prospective cohort of 873 community acquired pneumonia patients from a previous multicentre study with 31 patients having confirmed Legionnaires' disease by positive antigen tests for Legionella pneumophila.
Results: Patients with Legionnaires' disease more frequently had low sodium levels (Na < 130 mmol/L) (43% versus 8%, p < 0.01), but similar median CT-ProVasopressin levels (pmol/l) (20 [12-26] versus 26 [13-53], p = 0.89) as compared to patients with pneumonia of other etiologies. In patients with Legionnaires' disease, CT-ProVasopressin levels showed a positive correlation with sodium (r = 0.42, p < 0.05). Independent of pneumonia etiology, CT-ProVasopressin correlated significantly with the pneumonia severity index (r = 0.56, p < 0.05), ICU admission (odds ratio per decile, 95% CI) (1.4, 1.2 - 1.6), and 30-day-mortality (1.3, 1.2 - 1.4).
Conclusion: While Legionnaires’ disease was associated with hyponatremia, no concurrent increase in CT-ProVasopressin levels was found, which argues against SIADH as the causal pathway to hyponatremia. Rather, Vasopressin precursors were upregulated as response to stress in severe disease, which seems to overrule the osmoregulatory regulation of ADH.
Nothing to Disclose: PS, SH, MJC, WA, WZ, BM
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