Syndrome of inappropriate antidiuretic hormone secretion in patients with pneumonia
General Medicine, 2024, 26(3), 16-22.
M. Nikolova1, I. Kalinkova1, V. Kotseva1, D. Ivanova1, A. Kovachka1, C. Vutova1, N. Koleva1, M. Hristova1, D. Genov1, V. Grozeva1, A. Kostadinova1, B. Todorova2, A. Yordanov3, C. Marinova4, A. Petkov5, E. Mekov6, Y. Vlahov7, R. Gancheva8, M. Lazarov1, A. Iliev1, M. Nestorova1, J. Lazova1, V. Pavlova1, A. Kundurdjiev1
1 Clinic of Nephrology, University Hospital Sv. Iv. Rilski ‒ Sofia
2 Department of Diagnostic Imaging, University Hospital Sv. Iv. Rilski ‒ Sofia
3 Clinic of Hematology, University Hospital Sv. Iv. Rilski ‒ Sofia
4 Clinic of Gastroenterology, University Hospital Sv. Iv. Rilski ‒ Sofia
5 Department of Anesthesiology and Intensive Care, University Hospital Sv. Iv. Rilski ‒ Sofia
6 Clinic of Pneumology, University Hospital Sv. Iv. Rilski ‒ Sofia
7 Clinic of Endocrinology, University Hospital Sofiamed ‒ Sofia
8 Clinic of Rheumatology, University Hospital Sofiamed ‒ Sofia
Abstract. The syndrome of inappropriate antidiuretic hormone secretion (SIADH) consists of increased production of or response to ADH, which is inappropriate to plasma osmolality, with subsequent reduction of water clearance, water retention and dilutional hyponatremia. SIADH can develop due to changes in the central nervous system (trauma, infection, hemorrhage, space-occupying lesion of the brain), the intake of certain medications and controlled substances that increase the production of and/or the response to ADH, processes of the lung, certain solid tumors secreting ADH, intake of exogenous vasopressin, etc. We present a series of 10 patients who were treated and/or consulted in the Clinic of Nephrology for the period of 1 year and presented with dilutional hyponatremia in association with pneumonia. In all patients the successful treatment of lung infection led to resolution of hyponatremia. In conclusion, hyponatremia is a common finding in hospitalized patients and requires pro-active investigations for the presence of SIADH, especially associated with lung parenchymal diseases.
Key words: syndrome of inappropriate ADH secretion, inflammatory conditions of lungs, diagnosis, treatment
Address for correspondence: Assoc Prof. Milena Nikolova, MD, e-mail: milena_i_dani@abv.bg