Long-Term Treatment of the Syndrome of Inappropriate Antidiuretic Hormone Secretion with Phenytoin

1979 ◽  
Vol 90 (1) ◽  
pp. 50 ◽  
Author(s):  
AMIR TANAY
Keyword(s):  
Antidiuretic Hormone ◽  
Hormone Secretion ◽  
Term Treatment ◽  
Inappropriate Antidiuretic Hormone Secretion ◽  
Antidiuretic Hormone Secretion ◽  
Long Term Treatment

The Pharmacologic Management of the Syndrome of Inappropriate Secretion of Antidiuretic Hormone

1986 ◽  
Vol 20 (7-8) ◽  
pp. 527-531 ◽  
Author(s):  
Clyde I. Miyagawa
Keyword(s):  
Adverse Effects ◽  
Antidiuretic Hormone ◽  
Comparative Studies ◽  
Hormone Secretion ◽  
Term Treatment ◽  
Loop Diuretics ◽  
Treatment Modalities ◽  
Study Patient ◽  
Long Term Treatment

There have been numerous treatment modalities reported in the literature concerning the acute and chronic treatment of the syndrome of inappropriate antidiuretic hormone secretion (SIADH). Water restriction remains the mainstay of therapy. However, patient noncompliance for this regimen often makes additional treatment modalities necessary. In the long-term treatment of chronic SIADH, lithium, demeclocycline, loop diuretics, and urea are helpful, regardless of the origin of the SIADH. The use of lithium is not recommended due to the incidence of digestive, cardiac, thyroid, and central nervous system side effects, as well as the demonstrated superiority of demeclocycline. Urea and loop diuretics, although shown to be effective, have not been used clinically to the extent as demeclocycline, and are not free of adverse effects. Phenytoin is limited in its use to the treatment of SIADH secondary to abnormalities of the hypothalamic-pituitary axis, and plays no role in the treatment of tumor-induced SIADH. Demeclocycline has been shown to be effective in all types of SIADH. The lack of comparative studies of long-term treatment regimens makes the selection of a regimen of choice difficult. At this point loop diuretics or demeclocycline appear to be the regimens of choice based primarily upon case reports and relatively small comparative study patient populations. Further comparative studies are needed in an attempt to identify the most efficacious regimen with the minimal incidence of adverse effects.

scholarly journals Persistent syndrome of inappropriate antidiuretic hormone secretion following traumatic brain injury

2015 ◽  
Vol 2015 ◽  
Author(s):  
Michael Dick ◽  
Sarah R Catford ◽  
Kavita Kumareswaran ◽  
Peter Shane Hamblin ◽  
Duncan J Topliss
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Antidiuretic Hormone ◽  
Hormone Secretion ◽  
Fluid Restriction ◽  
Vasopressin Receptor ◽  
Receptor Antagonists ◽  
Inappropriate Antidiuretic Hormone Secretion ◽  
Antidiuretic Hormone Secretion

Summary The syndrome of inappropriate antidiuretic hormone secretion (SIADH) can occur following traumatic brain injury (TBI), but is usually transient. There are very few case reports describing chronic SIADH and all resolved within 12 months, except for one case complicated by meningo-encephalitis. Persistent symptomatic hyponatremia due to chronic SIADH was present for 4 years following a TBI in a previously well 32-year-old man. Hyponatremia consistent with SIADH initially occurred in the immediate period following a high-speed motorbike accident in 2010. There were associated complications of post-traumatic amnesia and mild cognitive deficits. Normalization of serum sodium was achieved initially with fluid restriction. However, this was not sustained and he subsequently required a permanent 1.2 l restriction to maintain near normal sodium levels. Multiple episodes of acute symptomatic hyponatremia requiring hospitalization occurred over the following years when he repeatedly stopped the fluid restriction. Given the ongoing nature of his hyponatremia and difficulties complying with strict fluid restriction, demeclocycline was commenced in 2014. Normal sodium levels without fluid restriction have been maintained for 6 months since starting demeclocycline. This case illustrates an important long-term effect of TBI, the challenges of complying with permanent fluid restrictions and the potential role of demeclocycline in patients with chronic hyponatremia due to SIADH. Learning points Hyponatraemia due to SIADH commonly occurs after TBI, but is usually mild and transient. Chronic hyponatraemia due to SIADH following TBI is a rare but important complication. It likely results from damage to the pituitary stalk or posterior pituitary causing inappropriate non-osmotic hypersecretion of ADH. First line management of SIADH is generally fluid restriction, but hypertonic saline may be required in severe cases. Adherence to long-term fluid restriction is challenging. Other options include oral urea, vasopressin receptor antagonists and demeclocycline. While effective, oral urea is poorly tolerated and vasopressin receptor antagonists are currently not licensed for use in Australia or the USA beyond 30 days due to insufficient long-term safety data and specific concerns of hepatotoxicity. Demeclocycline is an effective, well-tolerated and safe option for management of chronic hyponatraemia due to SIADH.

scholarly journals Small cell carcinoma of the cervix complicated by syndrome of inappropriate antidiuretic hormone secretion: a case report

2021 ◽  
Vol 49 (2) ◽  
pp. 030006052098565
Author(s):  
Cai-Fu Zhao ◽  
Su-Fen Zhao ◽  
Ze-Qing Du
Keyword(s):  
Cell Carcinoma ◽  
Antidiuretic Hormone ◽  
Small Cell Carcinoma ◽  
Poor Prognosis ◽  
Hormone Secretion ◽  
Clinical Manifestations ◽  
Small Cell ◽  
Laboratory Examination ◽  
Inappropriate Antidiuretic Hormone Secretion ◽  
Antidiuretic Hormone Secretion

Small cell carcinoma of the cervix is a rare malignant tumor in the clinical setting. Clinical manifestations of this tumor are mostly similar to those of normal types of cervical cancer. Small cell carcinoma of the cervix only shows symptoms of neuroendocrine tumors, such as syndrome of inappropriate antidiuretic hormone secretion (SIADH). Most of the hyponatremia caused by SIADH can be managed after removal of the cause. Hyponatremia is a predictor of poor prognosis and can be used as an indicator of partial recurrence. We report a case of small cell carcinoma of the cervix complicated by SIADH. Our patient presented with irregular vaginal bleeding after menopause. After one cycle of chemotherapy, there was trembling of the limbs, and a laboratory examination showed low Na+ and low Cl− levels. After limited water intake, intravenous hypertonic saline, and intermittent diuretic treatment, the patient’s blood Na+ levels returned to normal. After a radical operation, the above-mentioned symptoms disappeared.

scholarly journals Syringomyelia associated with inappropriate antidiuretic hormone secretion

2014 ◽  
Vol 2014 (apr11 1) ◽  
pp. bcr2013202575-bcr2013202575
Author(s):  
P. Barros Alcalde ◽  
A. Gonzalez Quintela ◽  
M. Pena Seijo ◽  
A. Pose-Reino
Keyword(s):  
Antidiuretic Hormone ◽  
Hormone Secretion ◽  
Inappropriate Antidiuretic Hormone Secretion ◽  
Antidiuretic Hormone Secretion
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