SYNDROME OF INAPPROPRIATE ANTIDIURETIC HORMONE (SIADH)

ETIOLOGY

Excessive or inappropriate production of AVP predisposes to hyponatremia, reflecting water retention. The evaluation of hyponatremia is described in Chap. 1: Electrolytes. Etiologies of SIADH include neoplasms, lung infections, CNS disorders, and drugs (Table 172-1).

TABLE 172-1: Causes of Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
NeoplasmsNeurologic
 Carcinomas Guillain-Barré syndrome
  Lung Multiple sclerosis
  DuodenumDelirium tremens
  Pancreas Amyotrophic lateral sclerosis
  Ovary Hydrocephalus
  Bladder, ureter Psychosis
 Other neoplasms Peripheral neuropathy
  ThymomaCongenital malformations
  Mesothelioma Agenesis corpus callosum
  Bronchial adenoma Cleft lip/palate
  Carcinoid Other midline defects
  GangliocytomaMetabolic
  Ewing’s sarcoma Acute intermittent porphyria
Head traumaPulmonary
Infections Asthma
 Pneumonia, bacterial or viral Pneumothorax
 Abscess, lung or brain Positive-pressure respiration
 Cavitation (aspergillosis)Drugs
 Tuberculosis, lung or brain Vasopressin or desmopressin
 Meningitis, bacterial or viral Chlorpropamide
 Encephalitis Oxytocin, high dose
AIDS Vincristine
Vascular Carbamazepine
 Cerebrovascular occlusions, hemorrhage Nicotine
 Phenothiazines
 Cavernous sinus thrombosis Cyclophosphamide
Genetic Tricyclic antidepressants
 X-linked recessive Monoamine oxidase inhibitors
 (V2 receptor gene) Serotonin reuptake inhibitors

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