Syndrome of inappropriate antidiuretic hormone hypersecretion

Posted by e-Medical PPT Tuesday, August 24, 2010
Syndrome of inappropriate antidiuretic hormone hypersecretion(SIADH) is characterized by excessive release of antidiuretic hormone(vasopressin) from the posterior pituitary gland or another source.SIADH is commonly found in patients diagnosed with small cell carcinoma of the lung, pneumonia, brain tumors, head trauma, strokes, meningitis, encephalitis.This causes dilutional hyponatremia and all the consequences associated with that condition: headache, nausea, vomiting, and confusion may ensue. Severe hyponatremia may cause convulsions or coma.
In general, increased ADH causes water retention and extracellular fluid volume expansion without edema or hypertension, owing to Natriuresis. The water retention and sodium loss both cause hyponatremia, which is a key feature in SIADH. Hyponatremia and concentrated urine (UOsm more than 300 mOsm) are seen, as well as no signs of edema or dehydration. When hyponatremia is severe (sodium less than 120 mOsm), or acute in onset, symptoms of cerebral edema become prominent (irritability, confusion, seizures, and coma.

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