Water, electrolyte, and endocrine homeostasis in infants with bronchiolitis

D. Gozal, Andrew Colin, M. Jaffe, Z. Hochberg

Research output: Contribution to journalArticle

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Abstract

Twenty-two of 23 consecutive infants with bronchiolitis, 5.5 ± 3.5 mo of age, showed a 1.9 ± 1.4% increase in body weight, increased urinary osmolality of 737 ± 193 mmol/L with low plasma osmolality of 275 ± 4 mmol/L, and markedly elevated plasma antidiuretic hormone (ADH) levels of 114 ± 225 pg/mL. Increased ADH, which usually suppresses plasma renin activity, was associated with increased plasma renin activity of 11-55 ng angiotensin 1/mL/h (normal for age <10 ng angiotensin 1/mL/h). Hyperaldosteronism was evident from the low fractional excretion of sodium of 0.27 ± 0.2% and high fractional excretion of potassium of 21 ± 15%. Serum sodium concentrations were normal. All of the pathologic findings returned to normal when the brochiolitis subsided. A control group of 10 infants with nonrespiratory febrile illness did not show any of the above abnormalities. Thus, bronchiolitis of infancy is characterized by both increased ADH secretion and hyperreninemia with secondary hyperaldosteronism, which induce water retention but counterbalance each other with respect to serum sodium. Increased ADH secretion as well as increased plasma renin activity are not 'inappropriate', but rather suggest a response to the perception of hypovolemia by intrathoracic receptors. We therefore conclude that the clinical management of bronchiolitis requires close monitoring of body wt and plasma osmolality-urinary osmolality relationship; serum sodium levels may be misleading.

Original languageEnglish
Pages (from-to)204-209
Number of pages6
JournalPediatric Research
Volume27
Issue number2
StatePublished - Jan 1 1990
Externally publishedYes

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Bronchiolitis
Electrolytes
Homeostasis
Vasopressins
Osmolar Concentration
Water
Sodium
Renin
Hyperaldosteronism
Angiotensins
Serum
Hypovolemia
Potassium
Fever
Body Weight
Control Groups

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Gozal, D., Colin, A., Jaffe, M., & Hochberg, Z. (1990). Water, electrolyte, and endocrine homeostasis in infants with bronchiolitis. Pediatric Research, 27(2), 204-209.

Water, electrolyte, and endocrine homeostasis in infants with bronchiolitis. / Gozal, D.; Colin, Andrew; Jaffe, M.; Hochberg, Z.

In: Pediatric Research, Vol. 27, No. 2, 01.01.1990, p. 204-209.

Research output: Contribution to journalArticle

Gozal, D, Colin, A, Jaffe, M & Hochberg, Z 1990, 'Water, electrolyte, and endocrine homeostasis in infants with bronchiolitis', Pediatric Research, vol. 27, no. 2, pp. 204-209.
Gozal D, Colin A, Jaffe M, Hochberg Z. Water, electrolyte, and endocrine homeostasis in infants with bronchiolitis. Pediatric Research. 1990 Jan 1;27(2):204-209.
Gozal, D. ; Colin, Andrew ; Jaffe, M. ; Hochberg, Z. / Water, electrolyte, and endocrine homeostasis in infants with bronchiolitis. In: Pediatric Research. 1990 ; Vol. 27, No. 2. pp. 204-209.
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