An experimental model of syndrome of inappropriate antidiuretic hormone secretion in the rat

1984 ◽  
Vol 247 (4) ◽  
pp. E540-E553 ◽  
Author(s):  
J. G. Verbalis

An experimental model of the syndrome of inappropriate antidiuretic hormone secretion (SIADH) was developed using continuous subcutaneous infusions of arginine vasopressin (AVP) or 1-desamino-8-D-arginine vasopressin (DDAVP) in conscious unrestrained rats drinking 5% dextrose solution. Retention of both ingested water and endogenously generated free water from tissue catabolism was the primary determinant of hyponatremia using either AVP or DDAVP infusions. Natriuresis occurred transiently following water expansion but only slightly further lowered plasma [Na+]. Cessation of antidiuretic infusion resulted in free water excretion with correction of plasma [Na+]. Erythrocyte cell volume was significantly increased in hyponatremic animals and intracellular [K+] and [Na+] both decreased equivalently, consistent with dilution of intracellular fluid by retained water. This model of SIADH differs significantly from those previously described, in that escape from the hydroosmotic effect of AVP and DDAVP does not occur in the absence of high urinary flow rates. The observed results using this model suggest that the retained water in SIADH primarily resides intracellularly following isotonic equilibration of extracellular fluid volume.

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Masanori Hasebe ◽  
Jun Shirakawa ◽  
Daisuke Miyashita ◽  
Rieko Kunishita ◽  
Mayu Kyohara ◽  
...  

Abstract Background Syndrome of inappropriate antidiuretic hormone secretion can be caused by arginine-vasopressin-producing tumors or enhanced arginine vasopressin secretion from the posterior pituitary gland due to central nervous system disorders and intrathoracic diseases. Case presentation A 53-year-old Asian man was hospitalized with complaints of tremor and hiccups. Laboratory examination revealed findings suggestive of hypotonic hyponatremia due to syndrome of inappropriate antidiuretic hormone secretion. The patient did not complain of headache or photophobia, and showed no signs of meningeal irritation. Positron emission tomography–computed tomography revealed 18F-fluoro-deoxy-glucose accumulation along the cervical spinal cord, based on which the patient was diagnosed as having aseptic meningitis. The hyponatremia was treated successfully by fluid restriction, and optimum plasma sodium concentration was maintained by tolvaptan administration. Conclusions This case underscores the need to consider the possibility of mild meningitis as the cause of syndrome of inappropriate antidiuretic hormone secretion in patients without other identifiable cause.


1974 ◽  
Vol 76 (3) ◽  
pp. 625-628 ◽  
Author(s):  
Alex M. Landolt

ABSTRACT Post-operative inappropriate antidiuretic hormone (ADH) secretion was observed 6 times in a group of 26 patients without diabetes insipidus before surgery for craniopharyngioma. Fourteen patients with existing diabetes insipidus did not show this disturbance. Intravenous administration of diphenylhydantoin (250 mg q. 8 h) controlled the hyponatraemia during the interphase of abnormal urine concentration and established an increased transitory water excretion in an 8 year old child operated upon for craniopharyngioma.


1974 ◽  
Vol 76 (1) ◽  
pp. 53-58 ◽  
Author(s):  
Kerstin Olsson ◽  
Rigmor Kolmodin

ABSTRACT Relatively rapid (3.75 ml/min), unilateral intracarotid infusions of slightly hypertonic (0.35 m) galactose and glycerol solutions induced a water diuresis within 40 to 60 min in the non-hydrated goat. The response to equi-osmolal fructose solution was weaker and less consistent. The water diuresis was apparently due to an inhibition of the basic ADH secretion, since it could be inhibited temporarily by the administration of small amounts of arginine vasopressin. The corresponding intracarotid infusion of isotonic NaCl solution did not significantly alter the renal clearance of free water, nor did equivalent intrajugular infusions of the non-electrolyte solutions induce water diuresis. The results appear incompatible with the osmoreceptor theory, and support the assumption that a central, Na+ sensitive receptor system may be involved in the regulation of the ADH secretion.


Author(s):  
Ananth Pai ◽  
Saniya Pervin

Syndrome of inappropriate antidiuretic hormone secretion (SIADH) results in impaired water excretion and consequent water intoxication and hyponatremia. In patients with cancer, SIADH is most commonly driven by ectopic ADH production, a paraneoplastic syndrome frequently seen in small cell lung cancer. A 63 year old male presented with loss of appetite, vomiting and hiccups. No abnormalities were detected on physical examination. Upper gastrointestinal endoscopy showed a proliferative growth in the stomach and histopathology report confirmed gastric adenocarcinoma. His laboratory investigations revealed low serum sodium and further work up for SIADH confirmed the diagnosis. The patient was treated with hypertonic saline and he improved symptomatically. He was subsequently treated with two cycles of capecitabine and oxaliplatin. The patient was asymptomatic and maintained a serum sodium in the range of 120 to 130 mEq/L, with a serum sodium of 127 mEq/L on follow up.


1982 ◽  
Vol 16 (9) ◽  
pp. 699-700 ◽  
Author(s):  
Charles D. Ponte

Clinicians prescribing diuretics should be aware of the potential seriousness of the syndrome of inappropriate antidiuretic hormone secretion (SIADH), which is characterized by hyponatremia associated with an adequate circulation and an expanded extracellular fluid volume. This case report describes a suspected case of SIADH in an elderly man receiving hydrochlorothiazide for hypertension.


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