Syndrome of inappropriate antidiuretic hormone secretion
Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is a condition characterized by excessive release of antidiuretic hormone (ADH) from the posterior pituitary gland or other sources. This syndrome was first described in 1957 by Schwartz et al.
Etiology[edit | edit source]
SIADH can be caused by various conditions, including malignant diseases, pulmonary diseases, central nervous system disorders, and the use of certain medications. The most common cause of SIADH is malignancy, particularly small cell lung cancer.
Pathophysiology[edit | edit source]
In SIADH, the excessive release of ADH leads to water retention and hyponatremia, a condition characterized by low levels of sodium in the blood. This is due to the fact that ADH increases the permeability of the renal tubules, allowing water to be reabsorbed back into the bloodstream.
Clinical Features[edit | edit source]
The clinical features of SIADH are primarily related to hyponatremia. Symptoms can range from mild, such as nausea and malaise, to severe, including seizures and coma. The severity of symptoms is generally related to the rapidity of onset and the degree of hyponatremia.
Diagnosis[edit | edit source]
Diagnosis of SIADH is based on clinical findings and laboratory tests. The key diagnostic criteria include hyponatremia, low serum osmolality, high urine osmolality, and clinical euvolemia.
Treatment[edit | edit source]
The treatment of SIADH is primarily aimed at correcting the hyponatremia and treating the underlying cause. This may involve fluid restriction, administration of saline solution, or the use of medications such as vasopressin receptor antagonists.
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