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Related to SIADH: diabetes insipidus
SIADHSyndrome of Inappropriate Antidiuretic Hormone
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AKI, MODS, CCF, and SIADH were seen exclusively in patients having electrolyte imbalance (Table-III).
(15) Inappropriate-hypotonic fluid therapy, diuretic use, SIADH, congestive heart failure, renal-liver diseases, hypothyroidism, and adrenal insufficiency should be considered in the differential diagnosis of hyponatremia in hospitalized children.
The syndrome of inappropriate antidiuretic hormone (ADH) secretion (SIADH) is a disorder of impaired water excretion caused by the inability to suppress secretion of ADH (1).
There is a fair amount of data associating antidepressants with SIADH. The incidence of SIADH with selective serotonin reuptake inhibitors (SSRIs) varies greatly among studies, from .06% to 40%.
Many medications such as opiates, anti-depressants, anti-psychotic, or anti-epileptic drugs have been reported to cause SIADH. This effect is most common in certain predisposed patients, either because they usually take other medications that may produce it or because they are suffering from other conditions such as pain or surgery that might enhance it.
SIADH is defined as euvolemic hypotonic hyponatremia (serum sodium level of less than 135mmol/L), inappropriately elevated urine osmolality (usually more than 200 mmol/kg) relative to plasma osmolality, and an elevated urine sodium level (typically greater than 20 mmol/L) with normal renal, adrenal, and thyroid functions.
Nakatsuru et al., "Syndrome of Inappropriate Secretion of Antidiuretic Hormone (SIADH) in a Patient with Multiple Sclerosis," Japanese Journal of Medicine, vol.
The workup (Table 1) revealed a sodium level of 126 mmol/l without other electrolyte abnormalities, serum osmolality of 260 mOsm/kg, serum uric acid level of 2.0 mg/dl, normal cortisol, normal TSH, urine sodium of 45 mmol/l, and urine osmolality of 274 mOsm/kg, consistent with SIADH. Citalopram was thought to be the cause of SIADH and stopped.
Among the 11 reported cases of amiodarone-induced SIADH, 9 were men, 8 above 60 years, and one aged 58 years.
The syndrome of inappropriate antidiuresis (SIADH) is the predominant cause of hyponatremia and is characterized by an imbalanced secretion of the antidiuretic hormone arginine vasopressin (AVP) [1-3].
The initial impression was SIADH secondary to sodium valproate, recently treated pneumonia, and pain from the left supracondylar fracture.