SIADH

Syndrome of inappropriate antidiuretic hormone

SIADH: Some Concepts

ADH : ADH is a hormone synthesized in the hypothalamus and released when BP is low

Osmolality :measures the concentration of all chemical particles found in the fluid part of blood.

SIADH: Definition
Problem in which vasopressin(ADH) is secreted even when plasma osmolarity is low or normal. A decrease in plasma osmolarity normally

inhibits ADH production

Etiology:

Pathophisiology

Clinical Manifestations

Decreased/low urine output GI disturbances Signs of hyponatremia: lethargy, apathy, disorientation, muscle cramps, anorexia, agitation Signs of water toxicity: nausea, vomiting, personality changes, confused, combative Vital signs: tachycardia, hypothermia

Complications

Seizures Coma Cerebral edema Cerebral hemorrhage Pulmonary edema Muscle cramps or weakness Diminished Deep tendon reflexes

Na < 115 mEq/L

Diagnostic and Lab Tests

Laboratory findings in diagnosis of SIADH include: Euvolemic hyponatremia <134 mEq/L Low serum Osmolality POsm <275 mOsm/kg Urine osmolality >100mOsm/kg of water during hypotonicity Urine sodium concentration >40 mEq/L with normal dietary salt intake Other findings: Clinical euvolemia NO edema or ascites Low blood urea nitrogen (BUN) Normal serum creatinine Low uric acid
Imaging studies Chest XR can identify pulmonary disease and lung cancer CT scans to rule out brain tumors as the cause of inappropriate secretion

Therapeutic Management
Restriction

fluid intake Promote excretion of water Replace Sodium Treat underlying cause