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Category: Endocrinology

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Syndrome of inappropriate antidiuretic hormone overview

Published: July 10, 2009. Updated: August 09, 2009

Syndrome of inappropriate antidiuretic hormone (SIADH), is a condition characterized by excessive release of antidiuretic hormone (ADH or vasopressin) from the posterior pituitary gland or another source.

Clinical suspicion

Suspect when there is water retention (antidiuresis) associated with an empty bladder and dilutional hyponatremia. There is no hypertension or edema.

Diagnosis

Once suspected low serum sodium and osmolality accompanied by a high urine osmolality.

Treatment

Fluid restriction.

Demethylchlortetracycline (demeclocycline) in patients unresponsive to fluid restriction. It may cause photosensitivity.

Severe hyponatremia is treated by hypertonic saline combined with frusemide to avoid volume overload.


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