Spontaneous and Induced Water Intoxication in Two Cases of Hypopituitarism

It has been known for many years that patients with adrenocortical failure, whether this be primary or secondary to anterior hypopituitarism, are unable to excrete ingested water at the normal rate (Rowntree and Snell, 1931; Robinson et al., 1941; Levy et al., 1946). Less recognized is the possibility that patients with hypopituitarism may retain water in excess of electro- lytes while on ordinary diets and without apparent forcing of their fluid intake. Such water retention* would lead to dilution of body fluids (hypotonicity) and, finally, to symptoms of water intoxication. Whittaker and Whitehead (1954) have described the case of a patient with hypopituitarism whose death they attributed to spontaneous water intoxication. The present report describes two such cases in which a similar, though reversible, abnormality was observed.