Syndrome of inappropriate antidiuretic hormone secretion - Revision history

Ostermayer: /* Essential CriteriaSchwartz WB, Bennett W, Curelop S, Bartter FC. A syndrome of renal sodium loss and hyponatremia probably resulting from inappropriate secretion of antidiuretic hormone. American Journal of Medicine 1957 23 529–542 */

2022-02-28T00:18:47Z

Essential CriteriaSchwartz WB, Bennett W, Curelop S, Bartter FC. A syndrome of renal sodium loss and hyponatremia probably resulting from inappropriate secretion of antidiuretic hormone. American Journal of Medicine 1957 23 529–542

← Older revision		Revision as of 00:18, 28 February 2022
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	===Essential Criteria<ref>Schwartz WB, Bennett W, Curelop S, Bartter FC. A syndrome of renal sodium loss and hyponatremia probably resulting from inappropriate secretion of antidiuretic hormone. American Journal of Medicine 1957 23 529–542</ref>===		===Essential Criteria<ref>Schwartz WB, Bennett W, Curelop S, Bartter FC. A syndrome of renal sodium loss and hyponatremia probably resulting from inappropriate secretion of antidiuretic hormone. American Journal of Medicine 1957 23 529–542</ref>===
	*Effective serum osmolality <275 mOsm/kg		*Effective serum osmolality <275 mOsm/kg
			*Urine specific gravity > 1.015
	*Urine osmolality >100 mOsm/kg at some level of decreased effective osmolality		*Urine osmolality >100 mOsm/kg at some level of decreased effective osmolality
	*Clinical euvolemia		*Clinical euvolemia

ClaireLewis at 16:53, 29 September 2019

2019-09-29T16:53:35Z

← Older revision		Revision as of 16:53, 29 September 2019
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	***[[Subdural hematoma]]		***[[Subdural hematoma]]
	**Other		**Other
	***Acute intermittent porphyria		***[[Acute intermittent porphyria]]
	***Cerebellar and cerebral atrophy		***Cerebellar and cerebral atrophy
	***CNS lupus		***CNS [[lupus]]
	***[[Epilepsy]], [[Delirium tremens]]		***[[Epilepsy]], [[Delirium tremens]]
	***[[Multiple sclerosis]], [[Guillain-Barré Syndrome]]		***[[Multiple sclerosis]], [[Guillain-Barré Syndrome]]
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	*Ectopic ADH secretion due to neoplastic source		*Ectopic ADH secretion due to neoplastic source
	**Lung carcinoma, mesothelioma		**Lung carcinoma, mesothelioma
	**Duodenal, pancreatic, and colonic carcinomas		**Duodenal, pancreatic, and [[colon cancer\|colonic carcinomas]]
	**Adrenocortical, bladder/urothelial, ovarian, prostate, and cervical cancers		**Adrenocortical, bladder/urothelial, ovarian, prostate, and cervical cancers
	**[[Brain tumor]], [[leukemia]]/[[lymphoma]], carcinoid, neuroblastoma, thymoma, Ewing's sarcoma		**[[Brain tumor]], [[leukemia]]/[[lymphoma]], carcinoid, neuroblastoma, thymoma, Ewing's sarcoma
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	***[[Barbiturates]], [[thiopental]], [[Mono amine oxidase inhibitor toxicity\|MAOIs]], [[tricyclic antidepressants]]		***[[Barbiturates]], [[thiopental]], [[Mono amine oxidase inhibitor toxicity\|MAOIs]], [[tricyclic antidepressants]]
	***[[Opioids]]		***[[Opioids]]
	***[[Haloperidol]], phenothiazines		***[[Haloperidol]], [[phenothiazines]]
	***[[Carbamazepine]], [[oxcarbazepine]]		***[[Carbamazepine]], [[oxcarbazepine]]
	***Halothane, [[nitrous oxide]]		***Halothane, [[nitrous oxide]]
	***Bromocriptine		***[[Bromocriptine]]
	***Carbachol		***Carbachol
	**Chlorpropamide		**Chlorpropamide
	***[[Isoproterenol]]		***[[Isoproterenol]]
	***Nicotine		***[[nicotine toxicity\|Nicotine]]
	**ADH-potentiating		**ADH-potentiating
	***[[Griseofulvin]]		***[[Griseofulvin]]
	***Hypoglycemic agents – Metformin, phenformin, tolbutamide		***Hypoglycemic agents – [[Metformin]], phenformin, tolbutamide
	***Oxytocin (large doses)		***[[Oxytocin]] (large doses)
	***[[Indomethacin]], [[aspirin]], [[NSAIDs]]		***[[Indomethacin]], [[aspirin]], [[NSAIDs]]
	***[[Theophylline]]		***[[Theophylline]]
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	*Effective serum osmolality <275 mOsm/kg		*Effective serum osmolality <275 mOsm/kg
	*Urine osmolality >100 mOsm/kg at some level of decreased effective osmolality		*Urine osmolality >100 mOsm/kg at some level of decreased effective osmolality
	*Clinical ~~euvolaemia~~		*Clinical euvolemia
	*Urine sodium concentration >30 mmol/l with normal dietary salt and water intake		*Urine [[hyponatremia\|sodium concentration]] >30 mmol/l with normal dietary salt and water intake
	*Absence of adrenal, thyroid, pituitary or renal insufficiency		*Absence of adrenal, thyroid, pituitary or renal insufficiency
	*No recent use of diuretic agents		*No recent use of [[diuretic]] agents

	===Supplemental criteria===		===Supplemental criteria===
	*Serum uric acid <0.24 mmol/l (<4mg/dl)		*Serum uric acid <0.24 mmol/l (<4mg/dl)
	*Serum urea <3.6 mmol/l (<21.6mg/dl)		*Serum urea <3.6 mmol/l (<21.6mg/dl)
	*Failure to correct ~~hyponatraemia~~ after 0.9% saline infusion		*Failure to correct [[hyponatremia]] after 0.9% saline infusion
	*Fractional sodium excretion >0.5%		*Fractional sodium excretion >0.5%
	*Fractional urea excretion >55%		*Fractional urea excretion >55%
	*Fractional uric acid excretion >12%		*Fractional uric acid excretion >12%
	*Correction of ~~hyponatraemia~~ through fluid restriction		*Correction of [[hyponatremia]] through fluid restriction

	==Management<ref>Verbalis JG et al. Diagnosis, evaluation, and treatment of hyponatremia: expert panel recommendations. Am J Med. 2013 Oct;126(10 Suppl 1):S1-42.</ref>==		==Management<ref>Verbalis JG et al. Diagnosis, evaluation, and treatment of hyponatremia: expert panel recommendations. Am J Med. 2013 Oct;126(10 Suppl 1):S1-42.</ref>==

Kxl328: /* ManagementVerbalis JG et al. Diagnosis, evaluation, and treatment of hyponatremia: expert panel recommendations. Am J Med. 2013 Oct;126(10 Suppl 1):S1-42. */

2018-11-06T17:52:48Z

ManagementVerbalis JG et al. Diagnosis, evaluation, and treatment of hyponatremia: expert panel recommendations. Am J Med. 2013 Oct;126(10 Suppl 1):S1-42.

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	**All sodium will be excreted, urine osmolality will remain high		**All sodium will be excreted, urine osmolality will remain high
	**Half of the bolus of normal saline will be retained, worsening hyponatremia		**Half of the bolus of normal saline will be retained, worsening hyponatremia
			*See [[osmotic demyelination syndrome]] for excessively rapid overcorrection

	==Disposition==		==Disposition==

Kxl328: /* Management */

2018-11-06T17:49:51Z

Management

← Older revision		Revision as of 17:49, 6 November 2018
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	*Correction of hyponatraemia through fluid restriction		*Correction of hyponatraemia through fluid restriction

	==Management==		==Management<ref>Verbalis JG et al. Diagnosis, evaluation, and treatment of hyponatremia: expert panel recommendations. Am J Med. 2013 Oct;126(10 Suppl 1):S1-42.</ref>==
	*See [[hyponatremia]]		*See [[hyponatremia]]
			*Fluid restriction
			*Oral salt tablets (NaCl) for mild-moderate hyponatremia
			*100 cc bolus of 3% NaCl for severe symptoms, repeat if neurologic symptoms persist or worsen
			**Ideally given through central line
			*DO NOT give normal saline 0.9%
			**In SIADH, sodium handling is intact and renal system will excrete Na
			**Water handling out of balance from excessive ADH
			**All sodium will be excreted, urine osmolality will remain high
			**Half of the bolus of normal saline will be retained, worsening hyponatremia

	==Disposition==		==Disposition==

Kxl328: /* Clinical Features */

2018-11-06T17:42:22Z

Clinical Features

← Older revision		Revision as of 17:42, 6 November 2018
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	==Clinical Features==		==Clinical Features==
	*See [[hyponatremia]]		*See [[hyponatremia]]
			*Symptoms of neoplasm, particularly lung neoplasm

	==Differential Diagnosis (Causes)==		==Differential Diagnosis (Causes)==

Kxl328: /* Disposition */

2018-11-06T17:41:50Z

Disposition

← Older revision		Revision as of 17:41, 6 November 2018
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	==Disposition==		==Disposition==
			*See [[hyponatremia]]

	==References==		==References==

Kxl328: /* Management */

2018-11-06T17:41:41Z

Management

← Older revision		Revision as of 17:41, 6 November 2018
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	==Management==		==Management==
			*See [[hyponatremia]]

	==Disposition==		==Disposition==

Kxl328: /* Clinical Features */

2018-11-06T17:41:31Z

Clinical Features

← Older revision		Revision as of 17:41, 6 November 2018
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	==Clinical Features==		==Clinical Features==
			*See [[hyponatremia]]

	==Differential Diagnosis (Causes)==		==Differential Diagnosis (Causes)==

Rossdonaldson1 at 22:15, 15 February 2018

2018-02-15T22:15:50Z

← Older revision		Revision as of 22:15, 15 February 2018
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	*Abbreviation: SIADH		*Abbreviation: SIADH
	*Inappropriate or continued action of ADH despite normal/increased plasma volume→ impaired water excretion→ hyponatremia and hypo-osmolality		*Inappropriate or continued action of ADH despite normal/increased plasma volume→ impaired water excretion→ hyponatremia and hypo-osmolality
	===Causes===
			==Clinical Features==

			==Differential Diagnosis (Causes)==
	*Inappropriate or hypersecretion from hypothalamus		*Inappropriate or hypersecretion from hypothalamus
	**Infectious		**Infectious
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	***Vasopressin analogs (eg, AVP, [[DDAVP]])		***Vasopressin analogs (eg, AVP, [[DDAVP]])

	~~==Clinical Features==~~
	==Evaluation==		==Evaluation==
	===Essential Criteria<ref>Schwartz WB, Bennett W, Curelop S, Bartter FC. A syndrome of renal sodium loss and hyponatremia probably resulting from inappropriate secretion of antidiuretic hormone. American Journal of Medicine 1957 23 529–542</ref>===		===Essential Criteria<ref>Schwartz WB, Bennett W, Curelop S, Bartter FC. A syndrome of renal sodium loss and hyponatremia probably resulting from inappropriate secretion of antidiuretic hormone. American Journal of Medicine 1957 23 529–542</ref>===
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	*Absence of adrenal, thyroid, pituitary or renal insufficiency		*Absence of adrenal, thyroid, pituitary or renal insufficiency
	*No recent use of diuretic agents		*No recent use of diuretic agents

	===Supplemental criteria===		===Supplemental criteria===
	*Serum uric acid <0.24 mmol/l (<4mg/dl)		*Serum uric acid <0.24 mmol/l (<4mg/dl)
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	*Fractional uric acid excretion >12%		*Fractional uric acid excretion >12%
	*Correction of hyponatraemia through fluid restriction		*Correction of hyponatraemia through fluid restriction
	==~~Etiology~~==
	*Extensive differential to include categories in CNS disorders, neoplastic, pulmonary, drug-induced		==Management==
	*See more here - [http://emedicine.medscape.com/article/246650-overview#a5 eMedicine, etiologies]
			==Disposition==

	==References==		==References==

Rossdonaldson1: Rossdonaldson1 moved page Syndrome of Inappropriate Antidiuretic Hormone Secretion to Syndrome of inappropriate antidiuretic hormone secretion

2018-02-15T22:12:57Z

Rossdonaldson1 moved page Syndrome of Inappropriate Antidiuretic Hormone Secretion to Syndrome of inappropriate antidiuretic hormone secretion

← Older revision	Revision as of 22:12, 15 February 2018
(No difference)