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inappropriate secretion of antidiuretic hormone:a rare complication after common bile duct exploration

Hepatobiliary & Pancreatic Diseases International 2009年第5期8卷 544-546页

作者： Ruan, Yu Zhang, Wei Wang, Qing-Qing Zhejiang Univ Sch Med Dept Endocrinol Sri Run Run Shaw Hosp Hangzhou 310016 Zhejiang Peoples R China Zhejiang Univ Sir Run Run Shaw Inst Clin Med Hangzhou 310016 Zhejiang Peoples R China Zhejiang Univ Sch Med Affiliated Hosp 1 Dept Surg Hangzhou 310003 Zhejiang Peoples R China

BACKGROUND: The syndrome of inappropriate secretion of antidiuretic hormone (SIADH) as a dilutional hyponatremia is due to a pathological increase of antidiuretic hormone (ADH). It is characterized by hyponatremia and decreased serum osmolarity as well as an increase in urinary osmolarity. The most common etiological factors of this syndrome include diseases or trauma of the central nervous system and malignant tumor or inflammation of the lung. SIADH following abdominal surgery is rare. METHODS: We report the case of a 68-year-old woman who developed, 24 hours after common bile duct exploration and stone removal, continuous hyponatremia for 20 days and clinical manifestations of nausea, vomiting, and lethargy without focal neurological signs. RESULT: Laboratory examinations supported the diagnosis of SIADH. After therapy with fluid restriction, the patient recovered. CONCLUSION: There are diverse causes for SIADH. It is important to have kept this clinical possibility in mind in the differential diagnosis of refractory hyponatremia under any circumstances.

关键词： inappropriate antidiuretic hormone syndrome surgery hyponatremia

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Case of inappropriate ADH syndrome:Hyponatremia due to polyethylene glycol bowel preparation

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World Journal of Gastroenterology 2014年第34期20卷 12350-12354页

作者： Sun-Hye Ko Chul-Hyun Lim Jae-Young Kim Seung Hun Kang Myong Ki Baeg Hyun Jin Oh Division of Endocrinology and Metabolism Department of Internal MedicineCollege of MedicineThe Catholic UniversitySeoul 137-701South Korea Division of Gastroenterology Department of Internal MedicineCollege of MedicineThe Catholic University of KoreaSeoul 137-701South Korea

Colonoscopic screening has been reported to reduce deaths from colorectal *** bowel preparation is essential for this and safety is an important issue in choosing the *** glycol(PEG)is regarded as a safe method for cleansing,especially compared with oral sodium ***,we present a case of hyponatremia caused by the syndrome of inappropriate antidiuretic hormone(ADH)syndrome after PEG precolonoscopic cleansing resulting in generalized tonic-clonic seizures.A 62-year-old women had ingested PEG for precolonoscopic bowel *** waiting for the colonoscopy,she developed a stuporous mentality and generalized tonic-clonic seizures,which did not correlate with brain magnetic resonance *** serum sodium level was 113 mEq per liter and laboratory analyses were consistent with inappropriate ADH *** thyroid and adrenal functions were *** were no malignancies,infections,respiratory disorders or central nervous disorders and she had no history of taking either diuretics or other medications,which might have caused inappropriate ADH *** was treated with 3%hypertonic saline and showed a complete neurological recovery as her sodium levels ***-up visits showed the patient to have a normal sodium level without neurologic *** case shows that inappropriate ADH syndrome can be caused by PEG preparation,which implies that physicians have to be aware of the possible side effects of this colonic cleansing approach and mindful of the possible ensuing symptoms.

关键词： inappropriate antidiuretic hormone syndrome Colonoscopy Polyethyelene glycol Hyponatremia Seizure

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