Open AccessSyndrome of inappropriate antidiuretic hormone secretion: Revisiting a classical endocrine disorder
Author(s) -
Binu Parameswaran Pillai,
Ambika Gopalakrishnan Unnikrishnan,
Praveen V Pavithran
Publication year - 2011
Publication title -
indian journal of endocrinology and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.456
H-Index - 28
eISSN - 2230-9500
pISSN - 2230-8210
DOI - 10.4103/2230-8210.84870
Subject(s) - hyponatremia , medicine , fluid restriction , antidiuretic , syndrome of inappropriate antidiuretic hormone secretion , tolvaptan , intensive care medicine , electrolyte disorder , diuretic , endocrine system , hormone , pediatrics , endocrinology
Hyponatremia occurs in about 30% of hospitalized patients and syndrome of inappropriate antidiuretic hormone secretion (SIADH) is a common cause of hyponatremia. SIADH should be differentiated from other causes of hyponatremia like diuretic therapy, hypothyroidism and hypocortisolism. Where possible, all attempts should be made to identify and rectify the cause of SIADH. The main problem in SIADH is fluid excess, and hyponatremia is dilutional in nature. Fluid restriction is the main stay in the treatment of SIADH; however, cerebral salt wasting should be excluded in the clinical setting of brain surgeries, subarachnoid hemorrhage, etc. Fluid restriction in cerebral salt wasting can be hazardous. Sodium correction in chronic hyponatremia (onset >48 hours) should be done slowly to avoid deleterious effects in brain.