scholarly journals Early water intake restriction to prevent inappropriate antidiuretic hormone secretion following transsphenoidal surgery: low BMI predicts postoperative SIADH

2014 ◽  
Vol 171 (6) ◽  
pp. 711-716 ◽  
Author(s):  
Junko Matsuyama ◽  
Hidetoshi Ikeda ◽  
Shunsuke Sato ◽  
Koh Yamamoto ◽  
Genichiro Ohashi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Antidiuretic Hormone ◽  
Water Intake ◽  
Serum Sodium ◽  
Transsphenoidal Surgery ◽  
Hormone Secretion ◽  
Water Restriction ◽  
Inappropriate Antidiuretic Hormone Secretion ◽  
Antidiuretic Hormone Secretion ◽  
Daily Urine

ObjectiveThe goals of this study were to assess the incidence of and risk factors for the syndrome of inappropriate antidiuretic hormone secretion (SIADH) in patients following transsphenoidal surgery (TSS), and to validate the effectiveness of early prophylactic restriction of water intake.DesignRetrospective analysis was performed for 207 patients who had undergone TSS, including 156 patients not placed on early prophylactic water restriction. Sixty-four patients received treatment for SIADH.MethodsWe compared the incidence of SIADH between patients with and without early water intake restriction, and analyzed various risk factors for SIADH using statistical analyses.ResultsBMI was significantly lower for patients with SIADH than for those patients without SIADH. Statistical analysis revealed that the threshold BMI predicting SIADH was 26. Serum sodium levels on postoperative days 5–10 and daily urine volumes on postoperative days 5–10 were significantly lower in patients with SIADH than in those without SIADH. Postoperative body weight loss on days 6, 8, 10, and 11 was significantly higher in patients with SIADH. The incidence of SIADH after starting prophylactic water intake restriction (14%) was significantly lower than the rate before early water restriction (38%; P<0.05).ConclusionsSIADH is relatively common after TSS, and serum sodium concentrations and daily urine volumes should be carefully monitored. Patients with low preoperative BMI should be closely observed, as this represented a significant preoperative risk factor for SIADH. Early prophylactic water intake restriction appears effective at preventing postoperative SIADH.

Syndrome of Inappropriate Antidiuretic Hormone Secretion Associated With Congenital Hydrocephalus in a Dog

2009 ◽  
Vol 45 (5) ◽  
pp. 249-252 ◽  
Author(s):  
Robert E. Shiel ◽  
Manuel Pinilla ◽  
Carmel T. Mooney
Keyword(s):  
Antidiuretic Hormone ◽  
Hormone Secretion ◽  
Diagnostic Testing ◽  
Clinical Signs ◽  
Abnormal Behavior ◽  
Water Restriction ◽  
Current Case ◽  
Inappropriate Antidiuretic Hormone Secretion ◽  
Antidiuretic Hormone Secretion ◽  
Truncal Ataxia

A 13-month-old, male bichon frise was examined for the investigation of intermittent seizures, ataxia, abnormal behavior, polyuria, and polydipsia. At presentation, clinical and neurological examinations were unremarkable with the exception of mild truncal ataxia and a domed skull. Severe hyponatremia and hypoosmolality were identified, and following diagnostic testing a diagnosis of the syndrome of inappropriate antidiuretic hormone secretion (SIADH) was made. Magnetic resonance imaging revealed changes consistent with severe hydrocephalus. Water restriction resulted in increased serum osmolality and a reduction in severity of clinical signs. The current case report documents SIADH associated with hydrocephalus in a dog. Structural brain disease should be excluded before a diagnosis of idiopathic SIADH is made.

Syndrome of Inappropriate Antidiuretic Hormone Secretion Associated with Lisinopril

2000 ◽  
Vol 34 (2) ◽  
pp. 176-179 ◽  
Author(s):  
Zakir Hussain A Shaikh ◽  
Harris C Taylor ◽  
Praful V Maroo ◽  
Luis A Llerena
Keyword(s):  
Angiotensin Ii ◽  
Antidiuretic Hormone ◽  
Serum Sodium ◽  
Ace Inhibitors ◽  
Hormone Secretion ◽  
Angiotensin I ◽  
Inappropriate Antidiuretic Hormone Secretion ◽  
Spot Urine ◽  
Antidiuretic Hormone Secretion ◽  
The Brain

OBJECTIVE: To describe a case of the syndrome of inappropriate antidiuretic hormone secretion (SIADH) associated with lisinopril therapy. CASE SUMMARY: A 76-year-old white woman who was being treated with lisinopril and metoprolol for hypertension presented with headaches accompanied by nausea and a tingling sensation in her arms. Her serum sodium was 109 mEq/L, with a serum osmolality of 225 mOsm/kg, urine osmolality of 414 mOsm/kg, and spot urine sodium of 122 mEq/L. Diclofenac 75 mg qd for osteoarthritic pain and lisinopril 10 mg qd for hypertension was begun in 1990. Lisinopril was increased to 20 mg qd in August 1994 and to 20 mg bid prn in August 1996 for increasing blood pressure; metoprolol 50 mg qd was added in July 1996. A diagnosis of SIADH was postulated and further evaluation was undertaken to exclude thyroid and adrenal causes. After lisinopril was discontinued and the patient restricted to 1000 mL/d of fluid, serum sodium gradually corrected to 143 mEq/L. The patient was discharged taking metoprolol alone for her hypertension; serum sodium has remained ≥138 mEq/L through April 1999, 32 months after discharge, despite daily use of diclofenac. DISCUSSION: Angiotensin-converting enzyme (ACE) inhibitors in antihypertensive doses may block conversion of angiotensin I to angiotensin II in the peripheral circulation, but not in the brain. Increased circulating angiotensin I enters the brain and is converted to angiotensin II, which may stimulate thirst and release of antidiuretic hormone from the hypothalamus, eventually leading to hyponatremia. CONCLUSIONS: SIADH should be considered a rare, but possible, complication of therapy with lisinopril and other ACE inhibitors.

scholarly journals Unusual paraneoplastic syndrome of inappropriate antidiuretic hormone secretion with gastric cancer

2019 ◽  
Vol 7 (8) ◽  
pp. 3192 ◽  
Author(s):  
Ananth Pai ◽  
Saniya Pervin
Keyword(s):  
Antidiuretic Hormone ◽  
Serum Sodium ◽  
Paraneoplastic Syndrome ◽  
Hormone Secretion ◽  
Upper Gastrointestinal Endoscopy ◽  
Water Excretion ◽  
Inappropriate Antidiuretic Hormone Secretion ◽  
Antidiuretic Hormone Secretion ◽  
Proliferative Growth ◽  
Loss Of Appetite

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.

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