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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 Jan 14. 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 Jan 7. Epub 2019 Jan 7.

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.

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

Clin Med (Lond) 2018 Oct;18(5):430-432

Mater Dei Hospital, Tal-Qroqq, Malta.

A 69-year-old man developed reduced consciousness of sudden onset. Examination and parameters were normal, except for a Glasgow Coma Scale (GCS) score of six. Brain imaging and blood tests were also normal, except for high plasma ammonia. Read More

J Clin Res Pediatr Endocrinol 2018 Sep 27. Epub 2018 Sep 27.

Çukurova University Faculty of Medicine, Department of Pediatric Endocrinology, Adana, Turkey.

Inappropriate ADH syndrome (SIADH) may develop after intracranial surgery. SIADH in pediatric age is mostly seen in intracranial mass and not only after surgery. The management of these clinical conditions in patients is important for the clinical course of the patient. Read More

Case Rep Nephrol 2018 5;2018:3697120. Epub 2018 Sep 5.

Monmouth Medical Center, Long Branch, NJ 07740, USA.

Hyponatremia is a well-known medication related side effect of selective serotonin reuptake inhibitors; despite its association with escitalopram, the newest SSRI is very rare. We did a review of literature and came across only 14 reported case of this rare association of SIADH with escitalopram. We hereby report a case of a 93-year-old female who presented with generalized tonic-clonic seizure and was diagnosed with severe hyponatremia due to escitalopram-induced syndrome of inappropriate antidiuretic hormone secretion (SIADH). Read More

Neurol India 2018 Sep-Oct;66(5):1389-1391

Department of Endocrinology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Esophagus 2018 10 27;15(4):209-216. Epub 2018 Apr 27.

Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.

Background: Little is known about hyponatremia in patients with esophageal cancer treated with cisplatin-based chemotherapy. The aim of this study was to analyze the risk factors for hyponatremia and its effect on outcomes in patients with esophageal cancer treated with chemotherapy including cisplatin.

Methods: We retrospectively analyzed the records of 137 patients with esophageal cancer who received chemotherapy including cisplatin for the first time between January 2011 and December 2014. Read More

Clin J Am Soc Nephrol 2018 Nov 4;13(11):1627-1632. Epub 2018 Sep 4.

Renal-Electrolyte Division, Department of Medicine.

Background And Objectives: Current therapies for hyponatremia have variable effectiveness and tolerability, and in certain instances, they are very expensive. We examined the effectiveness, safety, and tolerability of urea for the treatment of inpatient hyponatremia.

Design, Setting, Participants, & Measurements: We identified all patients hospitalized at the University of Pittsburgh Medical Center between July 2016 and August 2017 with hyponatremia (plasma sodium <135 mEq/L) who received urea, including a subgroup of patients who received urea as the sole drug therapy for hyponatremia (urea-only treated). Read More

Rinsho Shinkeigaku 2018 Sep 31;58(9):560-564. Epub 2018 Aug 31.

Department of Neurology, International University of Health and Welfare Hospital.

After a 34-year-old female developed a headache and high fever, she was diagnosed with aseptic meningitis. On admission, neurological examinations revealed cerebellar limb ataxia, horizontal gaze paretic nystagmus, and pyramidal tract signs. Laboratory tests showed hyponatremia (129 mEq/l). Read More

Case Rep Med 2018 6;2018:9496149. Epub 2018 Aug 6.

Department of Neurosurgery, Saitama Sekishinkai Hospital, Saitama, Japan.

We treated a patient with neurosarcoidosis, which caused the syndrome of inappropriate secretion of antidiuretic hormone (SIADH), in whom diagnosis was performed using neuroendoscopy. The patient was a 56-year-old female who was hospitalized for hyponatremia and diagnosed with SIADH based on a detailed examination. During the course, she developed impaired consciousness due to acute hydrocephalus, which improved after ventricular drainage. Read More

BMJ Case Rep 2018 Aug 29;2018. Epub 2018 Aug 29.

Internal Medicine, Hopital Riviera-Chablais, Vevey, Switzerland.

Recreational drug use is a significant societal issue and remains a clinical challenge in emergency and critical care departments. We report on a 19-year-old woman admitted to hospital semiconscious and with severe hyponatraemia. Urinalysis was positive for methamphetamine and supported a diagnosis of hyponatraemia related to ecstasy use together with a syndrome of inappropriate antidiuretic hormone secretion (SIADH). Read More

Medicina (B Aires) 2018;78(4):290-293

Servicio de Anatomía Patológica, Hospital Universitario Privado de Córdoba, Argentina.

Prostate cancer is an extremely rare cause of syndrome of inappropriate antidiuretic hormone (SIADH) secretion. These tend to be aggressive tumors and SIADH can carry serious clinical consequences. A 64 years old patient was diagnosed with Gleason 4+3: 7 prostate adenocarcinoma in December 2014 and received hormonal blockade therapy. Read More

Intern Med 2018 15;57(16):2353-2357. Epub 2018 Aug 15.

Department of Endocrinology and Diabetes, Komaki City Hospital, Japan.

A 79-year-old woman without any cerebral hernia symptoms was hospitalized with hyponatremia. After syndrome of inappropriate antidiuretic hormone induced by drugs was diagnosed and water restriction implemented, the patient became comatose during overcorrection caused by the generation of a large volume of electrolyte-free urine. Once the serum sodium concentration was immediately relowered by the administration of desmopressin and 5% glucose solution, the patient's level of consciousness improved dramatically without osmotic demyelination syndrome (ODS) developing. Read More

Intern Emerg Med 2018 Dec 13;13(8):1167-1171. Epub 2018 Aug 13.

U.O.C. di Medicina Interna Con Stroke Care, Dipartimento Biomedico di Medicina Interna e Specialistica (Di.Bi.M.I.S.), University of Palermo, Palermo, Italy.

Renal salt wasting syndrome (RSW) is defined as a renal loss of sodium leading to hyponatremia and a decrease in extracellular fluid volume (ECV). Differentiation of this disorder from the syndrome of inappropriate antidiuretic hormone secretion (SIADH), a common cause of hyponatremia, can be difficult because both can present with hyponatremia and concentrated urine with natriuresis. Our clinical case about a 78-year-old woman with a recent fracture of the right femur not only confirms that this syndrome can occur in patients without intracranial pathologies (CT documented), but depicts how the hyponatremia caused by RSW can show a chronic, oscillating course. Read More

Consult Pharm 2018 Aug;33(8):446-449

Purpose: There are a limited number of case reports in the literature which describe hyponatremia/syndrome of inappropriate antidiuretic hormone (SIADH) induced by duloxetine.

Summary: This case report adds to the literature by describing a patient who developed hyponatremia/SIADH after two doses of duloxetine.

Conclusion: Hyponatremia/SIADH can develop rapidly after initiation of duloxetine. Read More

Am J Med Sci 2018 Jul 7;356(1):15-22. Epub 2018 Apr 7.

Division of Nephrology and Hypertension, New York University Winthrop Hospital, Mineola, New York.

Background: The approach to hyponatremia is in a state of flux, especially in differentiating syndrome of inappropriate antidiuretic hormone secretion (SIADH) from cerebral-renal salt wasting (RSW) because of diametrically opposite therapeutic goals. Considering RSW can occur without cerebral disease, we determined the prevalence of RSW in the general hospital wards.

Methods: To differentiate SIADH from RSW, we used an algorithm based on fractional excretion (FE) of urate and nonresponse to saline infusions in SIADH as compared to excretion of dilute urines and prompt increase in serum sodium in RSW. Read More

Gan To Kagaku Ryoho 2018 May;45(5):855-857

Division of Oral and Maxillofacial Biopathological Surgery, Dept. of Medicine of Sensory and Motor Organs, School of Medicine, Tottori University Faculty of Medicine.

We herein report a case of a consciousness disorder that was induced by the syndrome of inappropriate antidiuretic hormone secretion following cisplatin (CDDP) and 5 -fluorouracil (5-FU) chemotherapy in a patient with tongue cancer. A 72- year-old woman complained of tongue pain and was admitted to our hospital for neoadjuvant chemotherapy, under a diagnosis of tongue squamous cell carcinoma (T4aN2bM0). She was treated with CDDP and 5-FU. Read More

J Med Case Rep 2018 Jul 17;12(1):212. Epub 2018 Jul 17.

Department of Endocrinology, Diabetes and Metabolism of Centro Hospitalar de São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.

Background: Combined central diabetes insipidus and cerebral salt wasting syndrome is a rare clinical finding. However, when this happens, mortality is high due to delayed diagnosis and/or inadequate treatment.

Case Presentation: A 42-year-old white man was referred to neurosurgery due to a non-functional pituitary macroadenoma. Read More

J Med Case Rep 2018 Jul 11;12(1):202. Epub 2018 Jul 11.

Facultad de Medicina, Universidad Francisco Marroquín, 6 Avenida 7-55, zona 10, 01010, Guatemala City, Guatemala.

Background: Severe hyponatremia is rare when carbamazepine is used as monotherapy. It is common to encounter this imbalance in the hospital setting, but rare in the ambulatory one. Here, we present a case of hyponatremia secondary to carbamazepine use in an otherwise asymptomatic patient. Read More

Nephron 2018 10;140(1):31-38. Epub 2018 Jul 10.

Research Unit for the Study of Hydromineral Metabolism, Department of Internal Medicine, Erasme University Hospital, Free University of Brussels, ULB, Brussels, Belgium.

Background/aims: Hyponatremia secondary to distal diuretics intake could have a biochemical picture similar to the one observed in the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). In these patients, water retention is considered to be the main causal factor and solute depletion a secondary one.

Methods: We compared the level of cation (Na + K) depletion and water balance in patients with high or low uric acid levels (< 4 mg/dL or 238 µmol/L) or with high or low (< 30 mg/dL or 5 mmol/L) urea levels. Read More