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Z Gerontol Geriatr 2020 Jun 2. Epub 2020 Jun 2.

Universitätsklinik für Geriatrie, Medizinische Klinik 2 - Schwerpunkt Geriatrie, Klinikum Nürnberg, Paracelsus Medizinische Privatuniversität, Campus Nürnberg, Nürnberg, Deutschland.

Old age is a strong independent risk factor for hyponatremia. Dizziness, fatigue, reduced vigilance, cognitive impairment, gait deficits, nausea, vomiting, headache, falls, osteoporosis and fractures, coma and seizures are more frequent and severe than in middle-aged patients. Hyponatremia is mainly caused by the syndrome of inappropriate antidiuretic hormone (SIADH) secretion and also including drugs. Read More

Neurosurg Focus 2020 Jun;48(6):E9

2IIIrd Department of Medicine, and.

Objective: The purpose of this study was to analyze the clinical and biochemical outcome of consecutive patients with acromegaly after microscopic transsphenoidal surgery (MTS) at a single center over an 8-year period.

Methods: A retrospective analysis of patients with acromegaly treated via MTS between 2008 and 2015 at the authors' center was performed. The mean follow-up was 29 months (range 1-120 months). Read More

Cureus 2020 Apr 21;12(4):e7762. Epub 2020 Apr 21.

Pathology, San Giovanni Bosco Hospital, ASL Napoli 1 Centro, Naples, ITA.

Hyponatraemia is the most common electrolyte imbalance found in hospital population and worldwide thiazide and loop-diuretics are among the most widely used drugs. Syndrome of inappropriate antidiuresis diagnosis (SIAD) is complicated in the presence of diuretic therapy due to the misleading clinical assessment of the extracellular volume status, and in order to make SIAD diagnosis it is often necessary to withdraw diuretic therapy. Our study aimed to investigate the diagnostic role of these alternative markers of volume status, serum uric acid (sUA) and fractional excretion of uric acid (FEUA), in hyponatraemic patients treated with different diuretic drugs. Read More

Clin Neuropathol 2020 May 25. Epub 2020 May 25.

Only a few cases of syndrome of inappropriate antidiuretic hormone secretion (SIADH) in the setting of amyotrophic lateral sclerosis (ALS) have been described in the literature. We present the case of an 81-year-old male who developed severe hyponatremia following elective total hip replacement. His past medical history included prostate cancer, which was under surveillance, and ischemic heart disease. Read More

Medicine (Baltimore) 2020 May;99(20):e20129

Department of Geriatrics, National Clinical Key Specialty, Guangzhou First People's Hospital, School of Medicine, South China University of Technology.

Introduction: Drug-induced fever is easy to overlook in respiratory departments. High fever is a rare side effect of trihexyphenidyl, which can be used clinically to treat Parkinson's disease. Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is a group of clinical syndromes caused by various diseases, resulting in water retention and refractory hyponatremia. Read More

N Engl J Med 2020 May;382(20):1943-1950

From the Departments of Medicine (C.M.C., P.W.C.) and Neurology (E.B.P., J.J.L.), Massachusetts General Hospital, and the Departments of Medicine (C.M.C., P.W.C.) and Neurology (E.B.P., J.J.L.), Harvard Medical School - both in Boston.

Saudi J Kidney Dis Transpl 2020 Mar-Apr;31(2):515-520

Department of Kidney Transplantation, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.

Living kidney donation is safe and established but can lead to short- and long-term complications. Hyponatremia is the most common disorder of body fluid and electrolyte balance in clinical practice, associated with increased morbidity, mortality, and the length of hospital stay. A correct diagnosis of the etiology of hyponatremia is critical, both to determine correct management and prognosis. Read More

J Hypertens 2020 May 7. Epub 2020 May 7.

Istituto Auxologico Italiano, IRCCS, Department of Cardiovascular, Neural and Metabolic Sciences, S. Luca Hospital, Milan.

: The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is the most common cause of euvolemic hyponatremia, and many disorders have been associated with it. Baroreflex failure is a rare disorder characterized by extreme blood pressure (BP) fluctuations, most frequently caused by neck or head trauma and irradiation. We report a case of a 48-year-old patient referred to our department for asymptomatic hyponatremia and volatile hypertension. Read More

Eur J Obstet Gynecol Reprod Biol 2020 Apr 8;249:14-20. Epub 2020 Apr 8.

Thomas Jefferson University Hospital. 833 Chestnut, Philadelphia, Pennsylvania, 19107, United States. Electronic address:

Normal physiologic changes in pregnancy include mild hyponatremia. In some cases of preeclampsia, more significant hyponatremia has been associated with syndrome of inappropriate antidiuretic hormone secretion and hypervolemic hyponatremia. A 45-year-old gravida 2, para 0010 with a dichorionic twin gestation was diagnosed with preeclampsia at 30 weeks 6 days and noted to have concomitant hyponatremia of 125 mEq/L at our institution. Read More

Epilepsy Res 2020 Jul 19;163:106343. Epub 2020 Apr 19.

Research Institute of the McGill University Health Centre, Canada.

Background: Serum levels of anticonvulsants are commonly ordered; however, the clinical utility of these laboratory tests is unclear. Clarifying the significance of anticonvulsant drug levels is essential to allow physicians to make appropriate management decisions. We aimed to determine to what extent elevated serum levels of valproic acid (VPA) and carbamazepine (CBZ) correlate with laboratory indications of end-organ dysfunction. Read More

Neth J Med 2020 Apr;78(3):125-131

Department of Clinical Pharmacy and Pharmacology, Medical Centre of Leeuwarden, Leeuwarden, the Netherlands.

Background: Hyponatraemia due to the syndrome of inappropriate antidiuretic hormone secretion (SIADH) can pose a therapeutic challenge. After fluid restriction, urea is recommended as a second-line treatment by Dutch and European treatment guidelines. Data on this practice are still scarce. Read More

Eur J Case Rep Intern Med 2020 4;7(4):001444. Epub 2020 Mar 4.

Internal Medicine Department, Hospital Universitario Río Hortega, Valladolid, Spain.

Amyotrophic lateral sclerosis (ALS) rarely presents with hyponatraemia caused by syndrome of inappropriate antidiuretic hormone secretion (SIADH). We present a patient with hyponatraemia of multifactorial aetiology, in whom, after withdrawal of the drugs that contributed to this ionic alteration, SIADH secondary to ALS was confirmed. After initiating treatment with urea, sodium levels were normalized. Read More

Pediatr Nephrol 2020 Jul 30;35(7):1347-1350. Epub 2020 Mar 30.

Pediatric Nephrology Unit, Trousseau Hospital, APHP.6, DMU Origyne, Paris, France.

Background: Tolvaptan is a selective oral vasopressin V2-receptor antagonist. Some data have implicated stimulation of arginine vasopressin (AVP) as an important factor in oedema formation in a rodent model of nephrotic syndrome (NS) and adult NS patients. We report case of pediatric NS with severe hyponatremia efficiently treated by tolvaptan. Read More

Am J Kidney Dis 2020 Mar 19. Epub 2020 Mar 19.

Division of Nephrology, Department of Internal Medicine, Chiang Mai University, Chiang Mai, Thailand; Pharmacoepidemiology and Statistics Research Center, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand. Electronic address:

Rationale & Objective: First-line therapy for syndrome of inappropriate antidiuresis (SIAD) is fluid restriction. Additional treatment for patients who do not respond to fluid restriction are water restriction with furosemide or water restriction with furosemide and salt supplementation. However, the efficacy of these treatments has never been tested in a randomized controlled study. Read More

Gan To Kagaku Ryoho 2019 Dec;46(13):2042-2044

Dept. of Surgery, Yao Tokushukai General Hospital.

An 82-year-old woman underwent surgery for gastric cancer at another hospital in May 2007. The pathological diagnosis was pT4a, pN2, M1, CY1, pStage Ⅳ. Although postoperative chemotherapy was administered, recurrence was observed on the abdominal wall in March 2014, and she was treated usingchemotherapy and resection. Read More

Front Horm Res 2019 15;52:167-177. Epub 2019 Jan 15.

In clinical practice, several medications such as diuretics, psychotropic drugs, and anticonvulsants have been reported to be a frequent cause of hyponatremia. Drugs may cause hyponatremia either by affecting the homeostasis of sodium and water (e.g. Read More

Oxf Med Case Reports 2020 Jan 31;2020(1):omz136. Epub 2020 Jan 31.

Department of Diabetes and Endocrinology, North West Anglia Trust, Peterborough City Hospital, UK.

Autoantibodies to leucine-rich glioma-inactivated protein 1 (LGI-1) are associated with inflammation of the limbic system. Faciobrachial dystonic seizures are pathognomonic for LGI1-antibiodies and their treatment with immunotherapy is effective in seizure control with a potential to prevent cognitive decline. We report a 57-year-old man who presented to the emergency department with recurrent seizures, visual hallucinations and severe memory impairment over a seven-week period; he reported a background of alcohol excess. Read More

Gac Med Mex 2020 ;156(1):78-81

Servicio de Farmacia Hospitalaria, Complejo Asistencial Universitario de León, León. España.

Introduction: Tolvaptan introduction has constituted the main therapeutic novelty in the management of hyponatremia in recent years.

Objective: To describe the experience with this drug at Complejo Asistencial Universitario de León, Spain.

Method: Retrospective, observational study of tolvaptan outpatient use in a tertiary care hospital from March 2014 to August 2017. Read More

Cureus 2019 Dec 18;11(12):e6415. Epub 2019 Dec 18.

Nephrology, University of Virginia, Farmville, USA.

Syndrome of inappropriate antidiuretic hormone secretion may be a frequent accompaniment of aging without an obvious central nervous system or pulmonary disorder, tumor, or drugs as the confounding factor. Treatment is often warranted due to complex symptomatology that is often associated with unfavorable clinical outcomes. Although V-receptor antagonists are effective in increasing serum sodium, their side-effect profile and cost may be a barrier to its use. Read More

Clin Psychopharmacol Neurosci 2020 Feb;18(1):164-166

Department of Psychiatry, Inha University Hospital, Incheon, Korea.

Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is characterized by hyponatremia, low serum osmolality, and clinical euvolemia in the absence of diuretic medication. And the causes of SIADH are various, antipsychotic agents and traumatic brain injury (TBI) are well known. Quetiapine is often chosen to manage the maladaptive behavior of patients with post-TBI. Read More

Int J Clin Exp Pathol 2019 1;12(7):2758-2762. Epub 2019 Jul 1.

Lung Cancer Center, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University Chengdu, Sichuan, China.

The presence of Mallory-Weiss syndrome (MWS) in patients with small-cell lung cancer (SCLC) is uncommon. MWS is characterized by longitudinal superficial mucosal laceration at the esophagogastric junction and can be caused by a variety of causes, with upper digestive tract hemorrhage as the primary manifestation. SCLC is the most invasive histological subtype of lung cancer, and approximately a quarter of all SCLC patients undergo paraneoplastic syndrome of inappropriate antidiuretic hormone secretion, such as hyponatremia. Read More

Zhongguo Yi Xue Ke Xue Yuan Xue Bao 2019 Dec;41(6):787-792

Key Laboratory of Endocrinology of National Health Commission,Department of Endocrinology, PUMC Hospital,CAMS and PUMC,Beijing 100730,China.

To summarize and analyze the causes of hyponatremia in patients with brucellosis and explore the clinical manifestations of syndrome of inappropriate antidiuresis(SIAD)in patients with brucellosis. The clinical data of 111 patients with acute brucellosis who were treated in Peking Union Medical College Hospital from September 2011 to December 2017 were retrospectively reviewed.Hyponatremia was defined by serum sodium level lower than 135 mmol/L. Read More

Curr Opin Nephrol Hypertens 2020 Mar;29(2):213-220

Department of Medicine and Division of Nephrology and Hypertension, NYU Winthrop Hospital, Mineola, New York, USA.

Purpose Of Review: The topic of hyponatremia is in a state of flux. We review a new approach to diagnosis that is superior to previous methods. It simplifies identifying the causes of hyponatremia, the most important issue being the differentiation of the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) from cerebral/renal salt wasting (RSW). Read More

BMJ Case Rep 2019 Dec 29;12(12). Epub 2019 Dec 29.

Internal Medicne, SAUSHEC, Fort Sam Houston, Texas, USA.

Small cell carcinoma (SCC) of the bladder is a rare malignancy, representing less than 1% of bladder cancers diagnosed annually in the USA. In contrast to SCC of the lung, paraneoplastic syndromes are rarely documented in cases of extrapulmonary SCCs, particularly those of genitourinary origin. We present a case of SCC of the bladder presenting with paraneoplastic syndrome of inappropriate antidiuretic hormone, which resolved after treatment with sequential chemoradiation. Read More

Zhonghua Nei Ke Za Zhi 2020 Jan;59(1):29-34

Department of Endocrinology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China.

The study was aimed to investigate the prevalence and causes of hyponatremia in hospitalized patients, and to analyze the relationship between hyponatremia and mortality. A retrospective analysis was carried out in 525 patients with hyponatremia, who were older than 14 years old and hospitalized in the Zhoushan Hospital from Jan. 2014 to Apr. Read More

Rev Med Chil 2019 Jul;147(7):935-939

Departamentos de Medicina Interna y Endocrinología, Clínica Dávila, Santiago, Chile.

Phyllomedusa bicolor or Kambo is a frog that lives in the Amazon rainforest. It can release through its skin a substance used in healing rituals that are common among South-American tribes, as well as in urban people of America and Europe. We report a 41-year-old female patient who, during a healing ritual consumed ayahuasca (a drink obtained from the mixture of Banisteriopsis caapi, Psychotria viridis and Mimosa hostilis) and 12 hours later received the poison of Kambo Frog (Phyllomedusa bicolor) on superficial right shoulder skin burns. Read More

Rinsho Shinkeigaku 2020 Jan 17;60(1):51-56. Epub 2019 Dec 17.

Department of Neurology, National Hospital Organization Kumamoto Medical Center.

A 73-year-old man with a 5-day history of continuous hiccup, fever, and rapidly progressing paraplegia was admitted to our hospital. On admission, he exhibited dysarthria, complete paraplegia, and insentience of both lower limbs. Head and spine MRI showed abnormal, asymmetric lesions in the white matter, basal ganglia, and brainstem, and multiple spinal cord lesions. Read More

Blood Purif 2020 18;49(1-2):212-218. Epub 2019 Dec 18.

Renal-Electrolyte Division, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA,

Background: Hyponatremia is the most common electrolyte disorder encountered clinically. While acute and/or severe hyponatremia is commonly associated with significant symptoms, milder and more chronic forms of hyponatremia remain clinically inconspicuous. Recent evidence suggests that even milder forms of hyponatremia are associated with increased morbidity and mortality. Read More

Innov Clin Neurosci 2019 Jul-Aug;16(7-08):32-34. Epub 2019 Jul 1.

Dr. Nakamura is with the Department of Psychiatric Internal Medicine at Kosekai-Kusatsu Hospital in Hiroshima, Japan.

Psychotropic-induced hyponatremia is one of the most common electrolyte abnormalities observed in routine psychiatric practice. However, many features of hyponatremia mimic those seen in depression, which can lead to the condition being overlooked. Takotsubo cardiomyopathy, or apical ballooning syndrome (ABS), is a reversible cardiomyopathy that mimics acute myocardial infarction. Read More

Neural Regen Res 2020 Jun;15(6):1166-1168

CHR d'Orléans, Service d'Oncologie Médicale, Orléans, France.

BMJ Case Rep 2019 Dec 9;12(12). Epub 2019 Dec 9.

Endocrinology & Diabetes, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK.

We describe a 67-year-old man admitted from a mental health unit with an incidental finding of hyponatraemia on routine blood tests. Laboratory investigations were in keeping with syndrome of inappropriate antidiuretic hormone secretion (SIADH). He had been recently commenced on mirtazapine. Read More

Med Klin Intensivmed Notfmed 2020 Feb 2;115(1):29-36. Epub 2019 Dec 2.

Klinikum Braunschweig, Medizinische Klinik V (Nephrologie Ɩ Rheumatologie Ɩ Blutreinigungsverfahren), Salzdahlumer Straße 90, 38126, Braunschweig, Deutschland.

Hyponatremia (sodium <135 mmol/l) is the most common electrolyte disorder. Despite identical serum concentrations, clinical symptomatology can vary greatly from mild to life-threatening. Accordingly, individual patients require immediate active treatment, while the majority of (mostly oligosymptomatic) patients should first undergo differentiated diagnosis. Read More

Front Neurosci 2019 8;13:1170. Epub 2019 Nov 8.

Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China.

The differential diagnosis of syndrome of inappropriate antidiuretic hormone secretion (SIADH) and cerebral salt-wasting syndrome (CSWS) in patients with neurological disorders has been a perplexing clinical controversy. The purpose of this review is to summarize the characteristics and risk factors of patients with different types of neurological disorders complicated by hyponatremia (HN) and review various methods to distinguish SIADH from CSWS. Common neurological disorders with high rates of HN include subarachnoid hemorrhage (SAH), traumatic brain injuries, stroke, cerebral tumors, central nervous system (CNS) infections, and Guillain-Barré syndrome (GBS), which have their own characteristics. Read More

Eur Neurol 2019 13;82(1-3):32-40. Epub 2019 Nov 13.

Department of Internal Medicine, School of Medicine, University of Ioannina, Ioannina, Greece.

Background: Hyponatremia is frequent in acute stroke patients, and it is associated with worse outcomes and increased mortality.

Summary: Nonstroke-related causes of hyponatremia include patients' comorbidities and concomitant medications, such as diabetes mellitus, chronic kidney disease, heart failure, and thiazides. During hospitalization, "inappropriate" administration of hypotonic solutions, poor solute intake, infections, and other drugs, such as mannitol, could also lower sodium levels in patients with acute stroke. Read More

J Neonatal Perinatal Med 2019 Nov 5. Epub 2019 Nov 5.

Division of Pediatric Endocrinology, Department of Pediatrics, Leiden University Medical Centre, Leiden, Netherlands.

Background: Hyponatremia is a common laboratory finding in premature and ill neonates. When the degree of hyponatremia is more severe, the likelihood of a pathologic entity increases. In this case report we describe a premature neonate with severe hyponatremia due to the idiopathic syndrome of inappropriate antidiuretic hormone secretion (SIADH). Read More

Internist (Berl) 2020 Jan;61(1):91-95

Klinik für Innere Medizin I - Sektion Nephrologie, Zentrum für Innere Medizin, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland.

This article reports the case of a 43-year-old woman who presented to the emergency room with headache and paresthesia after a fall on the head while skiing. She had clinical signs of volume depletion and blood test showed severe hyponatremia. Cerebral imaging was unremarkable. Read More

Pediatr Int 2020 Mar 28;62(3):363-370. Epub 2020 Jan 28.

Department of Pediatrics, The University of Tokyo, Tokyo, Japan.

Background: The precise mechanism of hyponatremia in Kawasaki disease (KD) remains elusive because assessment of volume status based on serial changes in body weight is lacking in previous reports.

Methods: Seventeen patients who were diagnosed with KD and hyponatremia (serum sodium levels <135 mmol/L) were analyzed. Volume status was assessed based on serial changes in body weight. Read More

Medicine (Baltimore) 2019 Oct;98(43):e17586

Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Key Laboratory of Endocrinology of National Health Commission of the People's Republic of China, Beijing, China.

Rationale: Tolvaptan, an oral vasopressin V2 receptor antagonist, is a new approach for the treatment of adult patients with the syndrome of inappropriate antidiuresis (SIADH). However, dose-dependent side effect including rapid increase in serum sodium levels and liver injury, and the expensive price limit the long-term use of tolvaptan. We report a case of SIADH patient treated with intermittent lower dose of tolvaptan combined with fluid restriction. Read More

Cureus 2019 Aug 22;11(8):e5458. Epub 2019 Aug 22.

Oncology, Bassett Medical Center, Cooperstown, USA.

We report a rare case of severe hyponatremia due to cisplatin-induced syndrome of inappropriate secretion of antidiuretic hormone (SIADH) in a 74-year-old male with a history of squamous cell carcinoma of the tongue who presented with a five days history of worsening confusion. He was found to have severe hyponatremia. His clinical and laboratory findings were consistent with hyponatremia due to SIADH. Read More

Ther Adv Med Oncol 2019 27;11:1758835919877725. Epub 2019 Sep 27.

Division of Oncological Endocrinology, Department of Medical Sciences, University of Turin, Italy.

Background: Hyponatremia in cancer patients is often caused by the syndrome of inappropriate antidiuretic hormone secretion (SIADH). The aim of this observational multicenter study was to analyze the medical and economic implications of SIADH in this setting.

Methods: This study included 90 oncological patients from 28 Italian institutions that developed SIADH between January 2010 and September 2015. Read More

Med Clin (Barc) 2020 Jun 16;154(11):473. Epub 2019 Oct 16.

Servicio de Hematología y Hemoterapia, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España.

A A Pract 2019 Nov;13(10):386-388

Division of Pulmonology and Critical Care, Drexel University College of Medicine, Philadelphia, Pennsylvania.

Complex regional pain syndrome (CRPS) is a severely disabling condition that typically develops after an inciting traumatic event. Ketamine infusion in subanesthetic dose provides sustained analgesia in selected cases of CRPS. In general, ketamine treatment does not significantly affect electrolyte or water balance. Read More

Indian J Cancer 2019 Oct-Dec;56(4):320-324

Department of Cancer Epidemiology and Biostatistics, Regional Cancer Centre, Thiruvananthapuram, Kerala, India.

Background: Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is a well-known adverse effect of vincristine (VCR). Literature suggests that Asians are predisposed to develop SIADH following VCR administration. However, data regarding the occurrence of SIADH in children with malignancy are limited. Read More

Am J Kidney Dis 2020 02 10;75(2):272-286. Epub 2019 Oct 10.

Division of Nephrology, Department of Medicine, Duke University Medical Center, Durham, NC. Electronic address:

Overall body fluid concentration is regulated within a narrow range by the concerted action of the hypothalamic-pituitary axis to influence water intake through thirst and water excretion via the effect of vasopressin, or antidiuretic hormone, on renal collecting duct water permeability. Sodium is the principal extracellular cation; abnormalities in overall effective body fluid concentration, or tonicity, manifest as disturbances in serum sodium concentration. Depending on its severity and chronicity, hyponatremia can lead to significant symptoms, primarily related to central nervous system function. Read More

J Vet Res 2019 Sep 13;63(3):339-344. Epub 2019 Sep 13.

Department of Preclinical Sciences, Faculty of Veterinary Medicine, Warsaw University of Life Sciences, 02-786 Warsaw, Poland.

Introduction: A previous study on canine babesiosis showed low serum tonicity in affected dogs, which may result from syndrome of inappropriate antidiuretic hormone secretion (SIADH). This endocrine disorder was recognised in human malaria which is considered a disease with similar pathogenesis to canine babesiosis. The aim of this study was to investigate the occurrence of SIADH in babesiosis-afflicted dogs. Read More

Drug Discov Ther 2019 ;13(4):232-238

Department of Neurosurgery, Fukuoka University Chikushi Hospital.

We present a case of a patient with drug-induced hypersensitivity syndrome (DIHS) caused by salazosulfapyridine combined with syndrome of inappropriate secretion of antidiuretic hormone (SIADH) caused by interstitial pneumonia (IP). A 67-year-old man with a past history of rheumatism (RA) presented with right hemiparalysis and aphasia as the chief complaints. A diagnosis of left embolic cerebral infarction following trial therapy for RA based on computed tomography findings was made, and external decompression was performed. Read More

Intern Med 2020 Jan 11;59(1):107-112. Epub 2019 Sep 11.

Department of Diagnostic Pathology, JCHO Saitama Medical Center, Japan.

Paraneoplastic syndromes are frequently observed in lung cancer, especially in small cell lung cancer (SCLC). Although there have been many reports on paraneoplastic syndromes, few reports have been published on SCLC that simultaneously produces antidiuretic hormone (ADH) and adrenocorticotropic hormone (ACTH), and these reports described the prognosis of such cases as extremely poor. We herein present a rare case of a Japanese woman with SCLC accompanied by syndrome of inappropriate secretion of antidiuretic hormone (SIADH) and Cushing's syndrome. Read More

Eur J Case Rep Intern Med 2019 24;6(8):001188. Epub 2019 Jul 24.

Clinica Medica, University of Udine, Udine, Italy.

Tick-borne diseases (Lyme disease and tick-borne encephalitis) are becoming a major public health concern. Rapid and correct diagnosis is crucial for complicated cases but is often delayed because of low suspicion or unusual clinical presentation. In this paper the authors describe two atypical presentations of Lyme disease and tick-borne encephalitis in order to help clinicians resolve diagnostic challenges. Read More