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Int J Surg Case Rep 2019 Apr 5;58:45-47. Epub 2019 Apr 5.

Department of Thoracic Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara-shi, Kanagawa 252-0374, Japan. Electronic address:

Introduction: Thymic neuroblastoma with syndrome of inappropriate secretion of antidiuretic hormone (SIADH) in adults is an extremely rare and malignant neoplasm. Although the tumor is known to grow rapidly and have a poor prognosis, its etiology is still uncertain. In 2009, we described a case of thymic neuroblastoma with SIADH. Read More

CNS Drugs 2019 Apr 11. Epub 2019 Apr 11.

Pharmacovigilance Service, Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences L. Sacco, "Luigi Sacco" University Hospital, University of Milan ASST Fatebenefratelli-Sacco, Via G. B. Grassi, 74, 20157, Milan, Italy.

Background: Hyponatraemia induced by antidepressant drugs is a rare but potentially life-threatening adverse reaction. Whether it is associated with all or only some antidepressant drugs is still unclear. This needs to be clarified to guide antidepressant therapies, especially in patients with electrolytic imbalances. Read More

Oxf Med Case Reports 2019 Mar 29;2019(3):omz010. Epub 2019 Mar 29.

1U.O.C di Medicina Generale e Lungodegenza.

Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is considered the prevalent cause of hyponatremia in hospitalized patients. Neuroleptic malign syndrome (NMS) is an idiosyncratic drug reaction showing fever, dysautonomia and rigidity with increased levels of Creatinine-phosphokinase (CPK) dependent on leakage of muscle contents into the circulation and defined as rhabdomyolysis. Although different diagnostic criteria for NMS have been established, it should be recognized that atypical presentations occur, particularly during treatment with atypical antipsychotics. Read More

Clin Nephrol 2019 Apr 2. Epub 2019 Apr 2.

Aims: We attempted to classify 115 consecutive nonedematous hyponatremic patients according to their history and saline responsiveness. We hereby describe 6 out of them presenting a transient renal salt wasting (TRSW) state of unknown origin.

Materials And Methods: Six patients with an initial SNa of 126 ± 3 mEq/L were included in the study. Read More

Cureus 2019 Jan 17;11(1):e3905. Epub 2019 Jan 17.

Internal Medicine, Peterborough City Hospital, Peterborough, GBR.

The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is defined as hyponatremia with inappropriately concentrated urine in a euvolemic patient. SIADH is associated with a wide spectrum of clinical conditions. In the hospital, hyponatremia carries significant mortality with a prolonged duration of inpatient stay. Read More

Pediatr Radiol 2019 Apr 16;49(4):534-550. Epub 2019 Mar 16.

Department of Radiology, Boston Children's Hospital, 300 Longwood Ave., Boston, MA, 02215, USA.

Paraneoplastic syndromes are defined as clinical syndromes that are not related to direct tumor invasion or compression but are secondary to tumor secretion of functional peptides/hormones or related to immune cross-reactivity with normal host tissue. Paraneoplastic syndromes have a wide range of presentations and can present before the primary malignancy or tumor recurrence is diagnosed. They can mimic non-neoplastic processes, making detection, diagnosis and treatment difficult. Read More

Front Pharmacol 2019 18;10:76. Epub 2019 Feb 18.

Department of Physiology, National Cheng Kung University Medical College, Tainan, Taiwan.

Tolvaptan (TLV), an oral non-peptide antagonist of vasopressin V receptor, has been increasingly used for managements in patients with hyponatremia and/or syndrome of inappropriate antidiuretic hormone secretion. However, none of the studies have thus far been investigated with regard to its possible perturbations on membrane ion currents in endocrine or neuroendocrine cells. In our electrophysiological study, the whole-cell current recordings showed that the presence of TLV effectively and differentially suppressed the amplitude of delayed rectifier K () and M-type K current () in pituitary GH cells with an IC value of 6. Read More

BMJ Case Rep 2019 Mar 7;12(3). Epub 2019 Mar 7.

Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.

Hyponatraemia is a common electrolyte disturbance with multiple causes. We present a case of a 49-year-old Caucasian female with cholangiocarcinoma, who had a hyponatraemia which was initially assumed to be based on a syndrome of inappropriate antidiuretic hormone secretion as paraneoplastic phenomenon. At physical examination, hyperpigmentation was seen and multiple episodes with syncope were reported. Read More

J Renin Angiotensin Aldosterone Syst 2019 Jan-Mar;20(1):1470320319834409

1 Department of Internal Medicine, Ashikaga Red Cross Hospital, Japan.

Introduction:: Angiotensin-converting enzyme (ACE) inhibitors are one of the most commonly used medications for hypertension. Rarely, ACE inhibitors have the potential to cause a syndrome of inappropriate secretion of antidiuretic hormone (SIADH).

Case Presentation:: A 70-year-old woman with > 10 years ACE inhibitor therapy with normonatremia suddenly developed severe SIADH when she took a liquid diet in the uneventful perioperative period, with hemodynamic stability and no surgical complications. Read More

Pediatr Nephrol 2019 Mar 6. Epub 2019 Mar 6.

Department of Pediatric Nephrology, Dokuz Eylül University Medical Faculty, 35340, Balçova, İzmir, Turkey.

J Med Case Rep 2019 Mar 7;13(1):71. Epub 2019 Mar 7.

Department of Medicine, Palo Alto VA, Palo Alto, California, USA.

Background: Primary small cell carcinoma of the kidney is an extremely rare neoplasm. The clinical features of small cell carcinoma of the kidney are not well established due to its rarity and scarcity of case reports. We present an unusual case of small cell carcinoma of the kidney complicated by syndrome of inappropriate antidiuretic hormone secretion. Read More

Am J Case Rep 2019 Feb 27;20:258-262. Epub 2019 Feb 27.

Department of Neurosurgery, Southeastern Regional Medical Center, Lumberton, NC, USA.

BACKGROUND Development of syndrome of inappropriate antidiuretic hormone secretion or cerebral salt wasting has been commonly noted in post-traumatic brain injury, and this condition may lead to hyponatremia resulting in cerebral edema and possible cerebral herniation. However, the predominant topographic pattern of edema from hyponatremia has not been well documented. Unlike numerous reports on hyponatremia and vasospasm following aneurysmal subarachnoid hemorrhage, the data for traumatic brain injury patient are still limited. Read More

F1000Res 2019 4;8. Epub 2019 Feb 4.

Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari, Bari, Italy, 70125, Italy.

The alteration of water balance and related disorders has emerged as being strictly linked to the state of activation of the vasopressin-aquaporin-2 (vasopressin-AQP2) pathway. The lack of responsiveness of the kidney to the vasopressin action impairs its ability to concentrate the urine, resulting in polyuria, polydipsia, and risk of severe dehydration for patients. Conversely, non-osmotic release of vasopressin is associated with an increase in water permeability in the renal collecting duct, producing water retention and increasing the circulatory blood volume. Read More

Intern Med 2019 Feb 25. Epub 2019 Feb 25.

Department of Neurology, Asahikawa Medical Center, National Hospital Organization, Japan.

A 77-year-old woman who had taken a single oral dose of duloxetine subsequently developed a headache and nausea. On the first day, her serum sodium level was 135 mEq/L. She became confused on the third day. Read More

Intern Med 2019 Feb 25. Epub 2019 Feb 25.

Department of Psychiatric Internal Medicine, Kosekai-Kusatsu Hospital, Japan.

We encountered a case of syndrome of inappropriate antidiuretic hormone secretion (SIADH) caused by duloxetine, serotonin and norepinephrine reuptake inhibitor (SNRI). A 74-year-old woman complaining of severe lethargy was transferred to our emergency department. Her serum sodium level was 109 mEq/L. Read More

J Neurosurg 2019 Feb 22:1-11. Epub 2019 Feb 22.

OBJECTIVEFrailty, a state of decreased physiological reserve, has been shown to significantly impact outcomes of surgery. The authors sought to examine the impact of frailty on the short-term outcomes of patients undergoing transsphenoidal pituitary surgery.METHODSWeighted data from the 2000-2014 National (Nationwide) Inpatient Sample were studied. Read More

J Med Case Rep 2019 Feb 23;13(1):40. Epub 2019 Feb 23.

Department of Surgery, Teaching Hospital, Kandy, Sri Lanka.

Background: Hyponatremia is defined as a serum sodium level of less than 135 mEq/L in a patient. Although hyponatremia is not an uncommon laboratory finding, especially in the elderly, hunting for the etiology is a challenging issue for any clinician. The three first-line investigations that are required for further analysis are urine osmolality, serum osmolality, and urinary sodium levels in addition to clinical assessment of volume status. Read More

Crit Care Clin 2019 Apr 28;35(2):187-200. Epub 2019 Jan 28.

Intensive Care Unit, Royal Melbourne Hospital, 300 Grattan Street, Parkville, Victoria 3050, Australia.

Diabetes insipidus and the syndrome of inappropriate antidiuretic hormone secretion lie at opposite ends of the spectrum of disordered renal handling of water. Whereas renal retention of water insidiously causes hypotonic hyponatremia in syndrome of inappropriate antidiuretic hormone secretion, diabetes insipidus may lead to free water loss, hypernatremia, and volume depletion. Hypernatremia and hyponatremia are associated with worse outcomes and longer intensive care stays. Read More

Medicine (Baltimore) 2019 Feb;98(7):e14295

Department of Endocrinology, Affiliated Hospital of Guangdong Medical University, Guangdong Province, China.

Rationale: Hyponatremia is one of the most common electrolyte disorders in clinic. Due to the complicated etiology and the nonspecific clinical manifestations, the diagnosis of hyponatremia is a complicated process. A variety of clinical disorders can cause inappropriately increased antidiuretic hormone (ADH) secretion, leading to inappropriate water retention and consequent hyponatremia. Read More

Nihon Ronen Igakkai Zasshi 2019 ;56(1):67-73

Department of Internal Medicine, Sankoukai Miyazaki Hospital.

An 80-year-old woman who was hospitalized due to small subarachnoid hemorrhaging caused by a bruise in the left temporal region of the brain. Nausea/vomiting and malaise appeared after dinner on the fourth day of the illness. Head computed tomography showed that the post-traumatic status was almost normal; however, the sodium ion (Na) level was 114 mEq/L, indicating severe hyponatremia. Read More

Exp Hematol Oncol 2019 1;8. Epub 2019 Feb 1.

1Academic Department of Haematology, Coleman Byrne Unit, Beaumont Hospital/RCSI Medical School, Dublin 9, Ireland.

The development of hyponatremia due to syndrome of inappropriate antidiuretic hormone secretion (SIADH) is well recognised in multiple myeloma (MM). SIADH, due to either MM or Bortezomib can be hazardous as severe hyponatremia may develop if large volumes of hypotonic intravenous fluid are used as an adjunct to chemotherapy. We report a case of Bortezomib-induced SIADH, in whom the use of tolvaptan, a vasopressin receptor-2 antagonist, permitted the continuation of triple combination anti-MM therapy with lenalidomide, Bortezomib and dexamethasone (RVD) in a female with aggressive disease, without the development of hyponatremia. Read More

Ital J Pediatr 2019 Feb 6;45(1):23. Epub 2019 Feb 6.

University of Trieste, Piazzale Europa, 1, 34127, Trieste, Italy.

Background: Primary adrenal insufficiency (PAI) in children is an uncommon but severe condition which can be either inherited or acquired. It consists in clinical manifestation of defective production or ineffective action of endogenous glucocorticoids; deficiency in mineralocorticoids and adrenal androgens may coexist. Diagnosis of PAI in children and young people can be challenging; while adrenal crisis (acute decompensation) is a life-threatening condition, with patient presenting with characteristic features of hypoglycemia, hypotension, collapse and coma, chronic adrenal insufficiency may present with vague and non-specific symptoms, making the diagnosis more difficult. Read More

J Pediatr Pharmacol Ther 2018 Nov-Dec;23(6):494-498

Hyponatremia is one of the most common electrolyte abnormalities encountered in the clinical setting in hospitalized patients. The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is the leading cause of hyponatremia in most of these cases. While fluid restriction, hypertonic saline infusion, diuretics, and the treatment of underlying conditions constitute the first line of treatment of SIADH, in refractory cases, and especially for pediatric patients, there seems not to be any other choice for treatment. Read More

Acta Gastroenterol Belg 2018 Oct-Dec;81(4):542

Imelda Bonheiden, Belgium.

CEN Case Rep 2019 May 14;8(2):112-118. Epub 2019 Jan 14.

Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1, Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan.

Case 1: A 45-year-old man, admitted for symptomatic hyponatremia, was diagnosed with advanced small-cell lung cancer and severe hyponatremia due to the syndrome of inappropriate secretion of antidiuretic hormone. In addition to chemotherapy, the patient was treated with increased dietary salt intake (15 g/day), fluid restriction of 500 mL/day, and amino acid supplementation to maintain a urea load of 31 g/day. Due to the difficulty in changing his habit of drinking 2-3 L/day after discharge, tolvaptan was started. Read More

Clin Endocrinol (Oxf) 2019 Apr 25;90(4):630-636. Epub 2019 Jan 25.

Department of Diabetes and Endocrinology, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.

Objective: Hyponatraemia in hospitalized patients is common and associated with increased mortality. International guidelines give conflicting advice regarding the role of urea in the treatment of SIADH. We hypothesized that urea is a safe, effective treatment for fluid restriction-refractory hyponatraemia. Read More

Front Med (Lausanne) 2018 30;5:319. Epub 2018 Nov 30.

Division of Nephrology and Hypertension, Department of Medicine, NYU Winthrop Hospital, Mineola, NY, United States.

Our evaluation of hyponatremic patients is in a state of confusion because the assessment of the volume status of the patient and determinations of urine sodium concentrations (UNa) >30-40 mEq/L have dominated our approach despite documented evidence of many shortcomings. Central to this confusion is our inability to differentiate cerebral/renal salt wasting (C/RSW) from the syndrome of inappropriate secretion of antidiuretic hormone (SIADH), syndromes with diametrically opposing therapeutic goals. The recent proposal to treat most or all hyponatremic patients makes differentiation even more important and reports of C/RSW occurring without cerebral disease leads to a clinically important proposal to change cerebral to renal salt wasting (RSW). Read More

Tijdschr Psychiatr 2018;60(12):848-851

Hyponatremia, as a result of the syndrome of inappropriate antidiuretic hormone secretion (SIADH), is well known with the use of nearly all antipsychotics and mood stabilizers. The first symptoms are atypical and are not always mentioned by the patient. However, not recognising the syndrome in due time can be lethal. Read More

Rinsho Ketsueki 2018;59(11):2423-2427

Division of Hematology, Department of Medicine, Showa University School of Medicine.

Hyponatremia occurs while receiving bortezomib-containing combination therapy in multiple myeloma (MM) ; however, the mechanism of hyponatremia remains unclear. A 65-year-old female with MM was treated with bortezomib, lenalidomide, and dexamethasone. Fourteen days after chemotherapy initiation, she developed hyponatremia (serum sodium, 127 mEq/l, compared with 136 mEq/l before chemotherapy) with plasma hypo-osmolality and urine hyper-osmolality. Read More

Case Rep Oncol Med 2018 18;2018:4038397. Epub 2018 Oct 18.

Department of Medicine, Baystate Medical Center, University of Massachusetts Medical School, Springfield, MA, USA.

We present a case of small-cell lung cancer (SCLC) with syndrome of inappropriate antidiuretic hormone secretion (SIADH) in which serum sodium gradually normalized with the onset of hypertension, refractory hypokalemia, and chloride-resistant metabolic alkalosis due to ectopic adrenocorticotrophic hormone (ACTH) secretion (EAS). In this case report, we discuss the diagnostic challenges of dual paraneoplastic syndromes with SIADH and EAS, management of SCLC with paraneoplastic endocrinopathies, and their prognostic impact on SCLC. In addition, we discuss neuroendocrine differentiation and ectopic hormone production in relation to intratumoral heterogeneity in SCLC and propose tumor microenvironment and hormonal and metabolic dependence as important determinants of tumor growth and survival. Read More

Br J Haematol 2019 Jan 28;184(2):121. Epub 2018 Nov 28.

Division of Hematology and Rheumatology, Faculty of Medicine, Kindai University, Osakasayama-shi, Osaka, Japan.

Praxis (Bern 1994) 2018 Nov;107(24):1309-1315

1 Innere Medizin/Endokrinologie und Diabetologie, Luzerner Kantonsspital.

CME: Paraneoplastic Endocrine Syndromes Abstract. Paraneoplastic endocrine syndromes are caused by ectopic hormone production by malignant tumor cells. Knowledge of paraneoplastic endocrine syndromes may allow a timely diagnosis of the underlying cancer at a treatable stage and, on the other hand, appropriate treatment of the endocrine manifestations reduces morbidity and mortality of the affected patients. Read More

Rev Med Suisse 2018 Nov;14(628):2116-2120

Service de médecine interne, CHUV, 1011 Lausanne.

The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is defined by euvolemic hyponatremia due to an inappropriate retention of free water under the effect of antidiuretic hormone. It is underdiagnosed despite well-defined criteria. Diagnosis involves a precise evaluation of volemia and the elimination of differential diagnoses. Read More

Pediatr Clin North Am 2019 02;66(1):209-226

Pediatric Nephrology, Pediatric Dialysis, Division of Nephrology, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, The University of Pittsburgh School of Medicine, 4401 Penn Avenue, Pittsburgh, PA 15224, USA. Electronic address:

The syndrome of inappropriate antidiuresis (SIAD) is a common cause of hyponatremia in hospitalized children. SIAD refers to euvolemic hyponatremia due to nonphysiologic stimuli for arginine vasopressin production in the absence of renal or endocrine dysfunction. SIAD can be broadly classified as a result of tumors, pulmonary or central nervous system disorders, medications, or other causes such as infection, inflammation, and the postoperative state. Read More

Medicine (Baltimore) 2018 Nov;97(46):e13178

Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, Zhejiang, China.

Rationale: Hyponatremia following duloxetine treatment has been reported in patients with major depressive disorder, fibromyalgia, diabetic neuropathy, or sciatic pain. The manifestations of duloxetine-induced hyponatremia are varying in different individuals. The overall prognosis for this type of hyponatremia is favorable if properly managed. Read More

World J Clin Cases 2018 Nov;6(13):694-702

Department of Respiratory Medicine, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China.

We report a case of natural killer (NK)/T-cell lymphoma with concomitant syndrome of inappropriate antidiuretic hormone secretion (SIADH). The patient was a 64-year-old woman with a history of nasopharyngeal carcinoma of over 30 years. She was admitted with a chief complaint of intermittent fever for 2 mo. Read More

BMC Pulm Med 2018 Nov 14;18(1):169. Epub 2018 Nov 14.

Department of Pulmonary and Critical Care Medicine, Arrowhead Regional Medical Center, Colton, California, USA.

Background: Small cell lung carcinoma (SCLC) is one of the deadliest forms of lung cancer due to its poor prognosis upon diagnosis, rapid doubling time, and affinity for metastasis. As 60-70% of patients with SCLC have disseminated disease upon presentation, it is imperative to determine the extent of disease burden for treatment. As a neuroendocrine carcinoma, clinicians must pay close attention to abnormal findings in a smoker that could lead to earlier diagnosis and better prognostication. Read More

Case Rep Urol 2018 18;2018:1604016. Epub 2018 Oct 18.

Department of Laboratory Medicine and Surgical Pathology, St. Michael's Hospital, Room 2-101V, 30 Bond Street, Toronto, ON, Canada M5B 1W8.

[This corrects the article DOI: 10.1155/2014/136984.]. Read More

Am J Ther 2018 Oct 26. Epub 2018 Oct 26.

Pharmacy Department, Division of Medicines, Hospital Clinic Barcelona, Universitat de Barcelona, Spain.

Am J Case Rep 2018 Nov 12;19:1345-1349. Epub 2018 Nov 12.

Department of Nephrology, University of São Paulo, School of Medicine, São Paulo, SP, Brazil.

BACKGROUND Corpus callosum agenesis (CCA) is one of the most common congenital brain abnormalities, and is associated with neurodevelopmental and neuropsychiatric disorders. In CCA, defects in osmoregulation have been reported. This report presents a rare case of chronic hyponatremia associated with the syndrome of inappropriate antidiuresis (SIAD) in a woman with CCA. Read More

Indian J Crit Care Med 2018 Oct;22(10):746-748

Department of Anesthesiology, IMS BHU, Varanasi, Uttar Pradesh, India.

Hyponatremia causing seizure is a common cause for admission in the critical care unit. Here, we describe a peculiar case of seizure due to hyponatremia, associated with anti-voltage-gated potassium channel antibody syndrome. This case emphasizes that how a proper workup can unveil unusual but potentially treatable causes of hyponatremia. Read More

Zhongguo Yi Xue Ke Xue Yuan Xue Bao 2018 Oct;40(5):699-704

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

Traumatic brain injury(TBI)is a major cause of hypothalamopituitary dysfunction. TBI-related hypothalamopituitary dysfunction is more common in the acute phase. Disturbance of pituitary/gonadal axis and growth hormone axis,as well as posterior pituitary dysfunction including central diabetes insipidus and syndrome of inappropriate antidiuretic hormone secretion,are the most frequently seen. Read More

Swiss Med Wkly 2018 09 23;148:w14662. Epub 2018 Sep 23.

Medizinische Universitätsklinik des Kantonsspitals Baselland, Klinik für Innere Medizin, Liestal, Switzerland.

Background: Hyponatraemia is the most common electrolyte disorder encountered in hospitalised patients and has an impact on outcome and survival. However, the risk factors are not yet sufficiently known.

Aims Of The Study: This retrospective analysis was conducted with the primary objective to identify the incidence of hyponatraemia in patients, who need hospitalisation from any medical reason, focusing on the quality of treatment and the risk factors for recurrent or prolonged stay due to hyponatraemia. Read More

Paediatr Child Health 2018 Nov 21;23(7):e126-e133. Epub 2018 Mar 21.

Pediatrics Department, Hospital Universitario Ramón y Cajal, Universidad de Alcalá de Henares, Madrid, Spain.

Background: Hyponatremia (HN) < 135 mmol/L is a frequent finding in children with community-acquired pneumonia (CAP). We aimed to determine the proportion of syndrome of inappropriate antidiuretic hormone secretion (SIADH) among patients with CAP and HN. Moreover, we wished to investigate the relationship between HN and inflammatory markers, bacterial etiology and prognosis in hospitalized children with CAP. Read More

Front Pediatr 2018 11;6:273. Epub 2018 Oct 11.

Department of Nephrology, Children's National Health System, Washington, DC, United States.

Chromosome 1q21.1 deletion syndrome is associated with a wide variety of clinical features including mild to moderate mental retardation, microcephaly, cardiac abnormalities, and cataracts. We report an unusual case of a premature neonate with persistent hyponatremia, markedly elevated plasma arginine vasopressin level (32. Read More

BMJ Case Rep 2018 Oct 24;2018. Epub 2018 Oct 24.

Department of Medicine, Inova Health System, Falls Church, Virginia, USA.

The triphasic response of pituitary stalk injury has previously been described in a minority of patients following intracranial surgery, however, this phenomenon can also occur after traumatic brain injury. We present the case of a 20-year-old male who experienced the triphasic response of pituitary stalk injury (central diabetes insipidus, syndrome of inappropriate antidiuretic hormone and central diabetes insipidus again) after striking his head on a concrete curb. His history and presentation highlight the importance of recognising the distinctive symptoms of each individual stage of pituitary stalk injury, and using the appropriate diagnostic tools and therapies to guide further management. Read More

BMJ Case Rep 2018 Oct 17;2018. Epub 2018 Oct 17.

Department of Medicine, Infectious Diseases Division, Mater Dei Hospital, Msida, Malta.

The syndrome of inappropriate antidiuretic hormone (SIADH) secretion is a frequent cause of hyponatraemia. It is a dilutional hyponatraemia secondary to impaired urinary dilution in the absence of renal disease or any identifiable non-osmotic stimulus known to induce antidiuretic hormone secretion. SIADH can arise secondary to various respiratory tract infections; however, the association between SIADH and influenza A infection is described in only a few cases in the literature. Read More

Pituitary 2018 Oct 17. Epub 2018 Oct 17.

Academic Department of Endocrinology, Beaumont Hospital/RCSI Medical School, Dublin, Ireland.

Neurohypophysial dysfunction is common in the first days following traumatic brain injury (TBI), manifesting as dysnatremia in approximately 1 in 4 patients. Both hyponatremia and hypernatremia can impair recovery from TBI and in the case of hypernatremia, there is a significant association with excess mortality. Hyponatremia secondary to syndrome of inappropriate antidiuretic hormone secretion (SIAD) is the commonest electrolyte disturbance following TBI. Read More

Drugs Today (Barc) 2018 Sep;54(9):519-533

Department of Nephrology, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Spain.

Tolvaptan is an orally active antagonist of vasopressin (antidiuretic hormone [ADH]) V2 receptors. By blocking water reabsorption in kidney collecting ducts, it prompts renal free-water excretion and has been used for the treatment of hyponatremia, both euvolemic due to the syndrome of inappropriate ADH secretion, and hypervolemic due to liver cirrhosis and congestive heart failure. In the past few years, it has been shown that vasopressin and its second messenger cyclic adenosine monophosphate (cAMP) play an important role in the pathogenesis of autosomal dominant polycystic kidney disease (ADPKD). Read More