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Emergency: requires immediate attention
Syndrome of inappropriate antidiuretic hormone
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Emergency: requires immediate attention

Syndrome of inappropriate antidiuretic hormone

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Contributors: Shea A. Nagle BA, Benjamin L. Mazer MD, MBA, Christine Osborne MD, Michael W. Winter MD
Other Resources UpToDate PubMed

Synopsis

The syndrome of inappropriate antidiuretic hormone (SIADH) is defined by inappropriate secretion of antidiuretic hormone resulting in hyponatremia and hypoosmolality in the setting of normal or increased plasma volume, leading to impaired water excretion. SIADH is caused either by inappropriate secretion of antidiuretic hormone (ADH) from the hypothalamus or from an ectopic source. SIADH may arise from postoperative stress, pain, or nausea. It also commonly manifests as a paraneoplastic syndrome.

Causes of SIADH can be divided into the following categories:
Hyponatremia is the most common electrolyte derangement among hospitalized patients. Elderly patients, adults with cirrhosis or heart failure, patients with cancer, and children with pulmonary or gastrointestinal infections are at highest risk for developing SIADH.

Presenting symptoms relate to the rapidity of development of hyponatremia. Patients with slowly progressive hyponatremia are often asymptomatic, while those with rapid development of hyponatremia may present with headache, confusion, anorexia, malaise, or even seizures and coma. Physical examination often reveals a normotensive and euvolemic patient.

Codes

ICD10CM:
E22.2 – Syndrome of inappropriate secretion of antidiuretic hormone

SNOMEDCT:
55004003 – Syndrome of inappropriate vasopressin secretion

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed: 03/27/2019
Last Updated: 05/13/2019
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Emergency: requires immediate attention
Syndrome of inappropriate antidiuretic hormone
Print 1 Images
Syndrome of inappropriate antidiuretic hormone : Abdominal pain, Altered mental state, Fatigue, Headache, Nausea, Vomiting, Hyponatremia, Malaise, Confusion
Copyright © 2019 VisualDx®. All rights reserved.