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{| class="wikitable"
!
Disease
!Causes
|Symptoms
|Diagnosis and treatment
|- Diagnostic criteria of SIADH include:


|SIADH
|SIADH is a syndrome characterized by excessive release of [[Vasopressin|antidiuretic hormone]] (ADH or vasopressin) from the [[posterior pituitary]] gland or another source. The result is [[hyponatremia]], and sometimes fluid overload.
|symptoms are variable. Ranging from nausea/vomiting,cramps,depressed mood,irritability,confusion and hallucinations. In severe cases seizures ,stupor or coma may result.
|Hyponatremia <135 mmol/l


Decreased effective serum osmolality<275mosm
_NOTOC _
{{CMG}};{{AE}}{{Vbe}}


Urine sodium concentration>40mmol/litre
==Causes==
[[Hypogammaglobulinemia]] is caused by:


Plasma uric acid <200;FeUrate>12%
Immunodeficiency secondary to:
*[[Uremia]]
*Protein losing enteropathy
*[[Nephrotic syndrome]]
*Malnutrition
*Cirrhosis
*Hemodialysis
* Intestinal lymphangiectasia


Absence of edematous disease like cardiac failure, liver cirrhosis, nephrotic syndrome.
* Protein-losing gastroenteropathy
*[[Nephrotic syndrome]]
*[[Thymoma]] <ref name="pmid29881497">{{cite journal |vauthors=Aouadi S, Ghrairi N, Braham E, Kaabi M, Maâlej S, Elgharbi LD |title=[Acquired hypogammaglobulinemia associated with thymoma: Good syndrome] |language=French |journal=Pan Afr Med J |volume=28 |issue= |pages=253 |date=2017 |pmid=29881497 |pmc=5989270 |doi=10.11604/pamj.2017.28.253.11352 |url=}}</ref>
* Medications :
** Gold
**D-Penicillamine
**Sulfasalazin
**Anticonvulsants
**Glucocorticoids
**Methotrexate
**Calcineurin inhibitors
** Rituximab<ref name="pmid29755528">{{cite journal |vauthors=Shoukat BA, Ali O, Kumar D, Bilal Gilani M, Zahid A, Aslam Joiya S, Anwar Malik M |title=Hypogammaglobulinemia Observed One Year after Rituximab Treatment for Idiopathic Thrombocytopenic Purpura |journal=Case Rep Med |volume=2018 |issue= |pages=2096186 |date=2018 |pmid=29755528 |pmc=5884289 |doi=10.1155/2018/2096186 |url=}}</ref><ref name="pmid29752554">{{cite journal |vauthors=Farhat L, Dara J, Duberstein S, De A |title=Secondary Hypogammaglobulinemia After Rituximab for Neuromyelitis Optica: A Case Report |journal=Drug Saf Case Rep |volume=5 |issue=1 |pages=22 |date=May 2018 |pmid=29752554 |pmc=5948191 |doi=10.1007/s40800-018-0087-y |url=}}</ref><ref name="pmid29627491">{{cite journal |vauthors=Thorlacius H, Jerkeman A, Marginean FE, Toth E |title=Colorectal malakoplakia in a patient with hypogammaglobulinemia |journal=Gastrointest. Endosc. |volume= |issue= |pages= |date=April 2018 |pmid=29627491 |doi=10.1016/j.gie.2018.04.001 |url=}}</ref>


normal adrenal and thyroid function
* Environmental hazards:
** Ionizing radiation
**Toxins


|-
*Infections
|Cerebral salt wasting
** Viral(Herpes, Measles)
| Cerebral salt wasting is defined as the renal loss of sodium during intracranial disease leading to hyponatremia and a decrease in extracellular fluid volume.
**Bacterial(Mycobacterial)
|polyuria,polydipsia,lightheadedness, muscle cramps,orthostatic hypotension,headaches
**Parasitic(Malaria, helminthic infections)
|The patient is hypovolemic and hyponatremic.
Treatment is with adequate hydration and sodium replacement.
|-
|Adrenal insufficiency
 
|Adrenal insufficiency ranges from mild nonspecific symptoms to life-threatening shock condition. An important distinction in these patients is the presence of mineralocorticoid deficiency. Those with secondary or tertiary adrenal insufficiency will typically have preserved mineralocorticoid function due to the separate feedback systems.
Adrenal insufficency can be primary, secondary or tertiary.
Common causes of primary adrenal insufficiency:
* Autoimmune
*Iatrogenic
*Drugs
*Others- adrenal hemorrhage, cancer, infection.
*congenital.
Secondary adrenal insufficiency refers to decreased adrenocorticotropic hormone (ACTH) stimulation of the adrenal cortex and therefore does not affect aldosterone levels. Traumatic brain injury (TBI) and panhypopituitarism are common causes.
Tertiary adrenal insufficiency refers to decreased hypothalamic stimulation of the pituitary to secrete ACTH. Exogenous steroid administration is the most common cause of tertiary adrenal insufficiency.
|
* fatigue
* muscle weakness
* loss of appetite
* weight loss
* abdominal pain
|
|-
|Hypopituitarism:
|Hypopituitarism is defined as the partial or complete loss of anterior pituitary function that can result from acquired or congenital causes.
Etiology is as follows:
*Pituitary tumors
*Sellar tumors
*Head trauma
*Infection
*empty sella
*infiltration
*Idiopathic
*congenital
|
Signs and symptoms of hypopituitarism vary, depending on the deficient
 
hormone  and severity of the disorder,some of the symptoms may be as follows:
* Fatigue
* Weight loss
* Decreased libido
* Decreased appetite
* Facial puffiness
* Anemia
* Infertility
* Cold insensitivity.
* amenorrha,inability to lactate in breast feeding women
* Decreased facial or body hair in men
* Short stature in children
|
|-
|Hypothyroidism
 
|Hypofunctioning of the thyroid gland due to multifactorial etiology ranging from congenital to autoimmune causes described below:
*Congenital
*Autoimmune
*Drugs
*Post surgery
*post radiation
*Infiltrative e.g., amyloid
|
* Fatigue
* Constipation
* Dry skin
* Weight gain
* Cold intolerance
* Puffy face
* Hoarseness
* Muscle weakness
* Elevated blood cholesterol level
* Bradycardia
* Myopathy
* Depression
* Impaired memory
|
|-
|Psychogenic polydipsia
| Also called as primary polydipsia is characterized by polyuria and polydipsia. Causes could be:
* Defect in the hypothalamus
*Adverse effect of a medication
*Traumatic brain injury
*Psychiatric disorders such as schizophrenia
|
|
|}

Latest revision as of 14:23, 3 August 2018


_NOTOC _ Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Vindhya BellamKonda, M.B.B.S [2]

Causes

Hypogammaglobulinemia is caused by:

Immunodeficiency secondary to:

  • Protein-losing gastroenteropathy
  • Nephrotic syndrome
  • Thymoma [1]
  • Medications :
    • Gold
    • D-Penicillamine
    • Sulfasalazin
    • Anticonvulsants
    • Glucocorticoids
    • Methotrexate
    • Calcineurin inhibitors
    • Rituximab[2][3][4]
  • Environmental hazards:
    • Ionizing radiation
    • Toxins
  • Infections
    • Viral(Herpes, Measles)
    • Bacterial(Mycobacterial)
    • Parasitic(Malaria, helminthic infections)
  1. ↑ Aouadi S, Ghrairi N, Braham E, Kaabi M, Maâlej S, Elgharbi LD (2017). "[Acquired hypogammaglobulinemia associated with thymoma: Good syndrome]". Pan Afr Med J (in French). 28: 253. doi:10.11604/pamj.2017.28.253.11352. PMC 5989270. PMID 29881497.
  2. ↑ Shoukat BA, Ali O, Kumar D, Bilal Gilani M, Zahid A, Aslam Joiya S, Anwar Malik M (2018). "Hypogammaglobulinemia Observed One Year after Rituximab Treatment for Idiopathic Thrombocytopenic Purpura". Case Rep Med. 2018: 2096186. doi:10.1155/2018/2096186. PMC 5884289. PMID 29755528.
  3. ↑ Farhat L, Dara J, Duberstein S, De A (May 2018). "Secondary Hypogammaglobulinemia After Rituximab for Neuromyelitis Optica: A Case Report". Drug Saf Case Rep. 5 (1): 22. doi:10.1007/s40800-018-0087-y. PMC 5948191. PMID 29752554.
  4. ↑ Thorlacius H, Jerkeman A, Marginean FE, Toth E (April 2018). "Colorectal malakoplakia in a patient with hypogammaglobulinemia". Gastrointest. Endosc. doi:10.1016/j.gie.2018.04.001. PMID 29627491.
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