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Results for “Inappropriate ADH Syndrome”

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PubMedDate not supplied

[Syndrome of inappropriate ADH secretion: a late complication of hemopoietic stem cell allograft].

An 11-year old boy with acute lymphoid leukemia underwent umbilical cord stem cell infusion. This was followed at day 15 by the onset of asymptomatic hypotonic isovolemic hyponatremia. The disorder could be attributed to a syndrome of inappropriate ADH secretion (SIADH), most probably related to the massive i.v. induction treatment with cyclophosphamide. The major causes and clinical variants of SIADH are reviewed, with particular emphasis on the complications of chemotherapy in hematological diseases. Worsening of hyponatremia during routine parenteral feeding, as opposed to normalization of plasma Na+ by infusion of hypertonic saline, emphasize the importance of early accurate diagnosis and careful follow-up of these iatrogenic sequelae of stem cell allograft.

Child↗
PubMed1991

[Syndrome of inappropriate ADH secretion (SIADH) in small-cell bronchus carcinoma].

Based upon the pertinent literature, the paraneoplastic syndrome of inappropriate antidiuretic hormone secretion (SIADH) in patients with small cell lung cancer is reviewed. Small cell lung cancer is a distinct tumor with neuroendocrine features capable of producing peptide hormones amongst which the antidiuretic hormone (ADH, arginine vasopressin) is one of the most frequent. Paraneoplastic SIADH may result from ectopic ADH production or from other tumor-related mechanisms leading to increased pituitary ADH secretion. The overt SIADH is characterized by neurological and psychiatric symptoms attributable to cerebral edema. Pooled published data suggest that the average incidence of clinically manifest SIADH in patients with newly diagnosed small cell lung cancer is 4%. Cases without clinical symptoms, detectable by laboratory tests only, are more frequent: hyponatremia, serum hypoosmolality and urine hyperosmolality are present in 14%, and an inappropriately elevated level of immunoreactive ADH in 38% of all patients respectively. Successful treatment of the underlying tumor, accompanied by a restricted fluid intake in severe cases, will usually result in prompt disappearance of the paraneoplastic SIADH. During and after the tumor treatment, plasma ADH may be useful as a tumor marker.

Biomarkers, Tumor↗
PubMed1997

Syndrome of inappropriate ADH secretion attributed to the serotonin re-uptake inhibitors, venlafaxine and paroxetine.

We report on 2 patients with the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) which developed a few weeks after they had started treatment with venlafaxine and paroxetine, respectively. Due to the temporal relationship and the exclusion of other potential causes, a causal relationship between the use of the antidepressants and SIADH seems likely. Diagnostic criteria for SIADH and the role of drugs, especially serotonin re-uptake inhibitors, are discussed.

Aged↗
PubMedDate not supplied

[Thrombophlebitis of the cavernous sinus and inappropriate ADH secretion syndrome].

The septic thrombosis of the cavernous sinus is a rare and serious disease which still occurs occasionally. The physician should be aware of this fact when treating infections of the nasal orbital areas. A case is presented in whom the septic thrombosis of the cavernous sinus is associated with the syndrome of inappropriate secretion of antidiuretic hormone.

Adolescent↗
PubMed1994

[Inappropriate ADH secretion syndrome and hypereosinophilia in Horton disease with stenosis of the subclavian arteries].

The authors describe a case of giant cell arteritis with subclavian involvement in association with a syndrome of inappropriate anti-diuretic hormone secretion and hypereosinophilia. Subclavian involvement, which may be the first symptom, occurs in five to twenty percent of giant cell arteritis. Hypereosinophilia, a frequent manifestation of specific granulomatosis vasculitis, is rarely described in association with giant cell arteritis. Dysfunction of the hypothalamo-pituitary axis such as inappropriate anti-diuretic hormone secretion or diabetes insipidus has been recently reported in giant cell arteritis. The syndrome of inappropriate anti-diuretic hormone secretion may either reveal the disease or occur during the evolution, in particular with gradual reduction of steroid treatment. It may be isolated, without clinical feature of arteritis and without an elevated erythrocyte sedimentation rate. This inappropriate anti-diuretic hormone secretion, probably due to ischemic involvement of the pituitary or hypothalamic region, always improves quickly after institution of steroid therapy.

Constriction, Pathologic↗
PubMed1992

[The incidence of the inappropriate ADH secretion syndrome (SIADH) in major otorhinolaryngologic surgery].

There are few works dealing with the presentation of the inadequate secretion of antidiuretic hormone in major ENT procedures. In this prospective study done by the AA., based in analytic data, they found out the presence of the syndrome in as many as 39 percent of those operations. Consequently the suggestion is made that major ENT-surgery must be considered among the potential factors of the syndrome.

Age Factors↗
PubMed1982

[Hypouricaemia in the syndrome of inappropriate ADH secretion (SIADH) (author's transl)].

A retrospective study of 22 patients with hyponatraemia (less than 130 mEq/l) was conducted to find out whether hypouricaemia was useful in the diagnosis of SIADH. Serum levels of uric acid were inferior to 38 mg/l in 9 out of 12 patients with SIADH but not in the remaining 10 patients without SIADH. The mechanism of hypouricaemia in the syndrome seems to be an increase in uric acid excretion, since water restriction reduces the fractional clearance of urates. The authors conclude that hypouricaemia appears to constitute a reliable means of detecting SIADH in patients with hyponatraemia.

Diagnosis, Differential↗
PubMed1991

[Small-cell lung carcinoma with hyponatremia].

Two female patients are described with an unusual clinical presentation of a small-cell bronchogenic carcinoma. Patient A, 61 years old, had a one week history of epigastric pain and nausea accompanied by dizziness and periods of unconsciousness. Patient B, 48 years old, had suffered for four days of general malaise, abdominal pains, nausea and vomiting. The symptoms of both patients could be attributed to severe hyponatraemia, most probably a consequence of the inappropriate ADH syndrome. After correction of the hyponatraemia and treatment of the underlying carcinoma the serum sodium remained normal and symptoms did not recur. The patients died 14 months and 9 months after the diagnosis respectively. In the Netherlands about 2000 small-cell bronchogenic carcinomas are diagnosed each year. About 14% of these are associated with the inappropriate ADH syndrome. The presence of the syndrome implicates a much graver prognosis.

Carcinoma, Small Cell↗
PubMed1983

Inappropriate antidiuretic hormone syndrome in craniofacial surgery.

Three instances of inappropriate ADH syndrome following craniofacial operations are reported. The cornerstone to diagnosis is careful fluid and electrolyte monitoring. Treatment consists of fluid restrictions in the acute phase and demeclocycline for refractory cases. Seizures should be symptomatically treated. Surgeons involved in the care of craniofacial anomalies must be aware of this syndrome because the symptoms closely mimic those commonly observed following intracranial procedures. If unrecognized, the consequence is potentially lethal.

Child↗
PubMed1981

Syndrome of inappropriate ADH secretion concealed by hypokalaemia due to ectopic ACTH production.

A case is described of a patient with an oat cell carcinoma of the bronchus with moderately elevated levels of plasma corticotrophin (ACTH) and antidiuretic hormone (ADH). Ectopic secretion of ACTH induced severe hypokalaemia and concealed the effects of concomitant ADH secretion on renal function. Normal renal responsiveness was restored following correction of hypokalaemia. The hypokalaemia was associated with evidence of a marked increase in corticosteroid secretion but plasma ACTH concentrations did not show a proportionate elevation. Chromatographic studies on tumour extracts suggest that the presence of a large fraction of high molecular weight ACTH in plasma could explain this discrepancy.

Adrenocorticotropic Hormone↗
PubMed2005

[Syndrome of inappropriate ADH secretion (SIADH) induced by pramipexole in a patient with Parkinson's disease].

An 85-year-old woman with Parkinson's disease was admitted to our hospital to conduct a further work-up for progressive gait disturbance. She had been on medications for the disease for more than a decade prior to admission. In order to improve her condition, she was newly administered pramipexole, a dopamine agonist, from day 3 in addition to the preceding anti-Parkinson's therapy. However, on day 10, her consciousness level was rapidly deteriorated into delirium(JCS II-10), which was not accompanied by neurological signs and symptoms. Laboratory tests showed severe hyponatoremia with relatively increased urinary sodium excretion, and severe low serum osmolarity with an increased urinary osmolarity. Brain CT and brain MRI showed no specific abnormalities except for those related to aging. Blood concentration of ADH measured at the onset was substantially higher(39.5 pg/ml) than normal (0.3-3.5 pg/ml under normal osmolarity). Diseases causing hyponatremia, such as liver cirrhosis, congestive heart failure, hypotonic dehydration, and malignancy-associated inappropriate ADH secretion (SIADH), were all excluded. Under the suspicion of SIADH due to pramipexole, the drug was discontinued and as a result, her consciousness level improved rapidly together with a prompt reduction in ADH level (9.2 pg/ml). To the best of our knowledge, the present case is the first that demonstrates pramipexole-induced SIADH. Since pramipexole is classified as a dopaminergic receptor agonist, this case may provide new insight into a link between ADH and the dopaminergic receptor in the central nervous system.

Aged↗