1 Children's Hospital of Philadelphia, 18th and Bainbridge Streets, Philadelphia, Pennsylvania
We thank Drs. Moore and Edelmann for their detailed comments.
Although inappropriate ADH release had occurred to us as a contributing factor, we had difficulty in explaining just why it would have arisen in these cases, and therefore did not mention it. But since, as Drs. Moore and Edelmann point out, inappropriate ADH is not well understood anyhow, perhaps we should not have been so reticent.
A hypothetical possibility is the existence in these children of a latent defect in renal function which became apparent only under conditions of stress, namely water-loading.