Case of Intrauterine Death Due to α-Thalassaemia

and because of the large numbers of tablets the patient was having to take. Furthermore, very frequent estimations of his electrolyte levels were required. Since it had been demonstrated by Lee et al. (1964) that the tumour itself was the source of production of a substance having antidiuretic-hormone activity, we felt that a direct attempt to suppress this with antimitotic agents might prove a more effective measure. The patient was therefore given a single dose of 40 mg. of nitrogen mustard (his weight at this time being 80 kg.; the dosage of the drug was 0.5 mg./kg.) and 10 days later the 9a-fluorohydrocortisone was withdrawn. Thereafter, serum sodium and potassium levels remained within normal limits; serum osmolarity rose and urine osmrlarity fell. For the first week after withdrawal of 9a-fluorohydrocortisone urine sodium loss increased again, but one month later had fallen to less than half its level before treatment. Over a follow-up period of three months the patient remained in normal electrolyte balance; no potassium or sodium supplements were required, and he complained only of a persistent cough.