Syndrome of inappropriate antidiuretic hormone differential diagnosis: Difference between revisions

Jump to navigation Jump to search
No edit summary
m (Bot: Removing from Primary care)
 
(112 intermediate revisions by 8 users not shown)
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{Syndrome of inappropriate antidiuretic hormone}}
[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Syndrome_of_inappropriate_antidiuretic_hormone]]
Please help WikiDoc by adding more content here.  It's easy!  Click  [[Help:How_to_Edit_a_Page|here]] to learn about editing.
{{CMG}}; {{AE}}{{Vbe}}


{{CMG}}
==Overview==
==Overview==
Syndrome of inappropriate antidiuretic hormone (SIADH) must be differentiated from other causes of [[hyponatremia]], such as [[cerebral salt wasting syndrome]], [[adrenal insufficiency]], [[hypopituitarism]], and [[psychogenic polydipsia]].
==Differentiating Syndrome of inappropriate antidiuretic hormone from other Diseases==
==Differentiating Syndrome of Inappropriate Antidiuretic Hormone from other Diseases==
[[Cerebral salt wasting syndrome]] also presents with hyponatremia, but is treated differently.
[[SIADH]] must be differentiated from cerebral salt wasting, [[ adrenal insufficiency]], [[hypopituitarism]], [[hypothyroidism]], and [[psychogenic polydipsia]].<ref name="pmid27936532">{{cite journal |vauthors=Heidelbaugh JJ |title=Endocrinology Update: Hypopituitarism |journal=FP Essent |volume=451 |issue= |pages=25–30 |year=2016 |pmid=27936532 |doi= |url=}}</ref><ref name="pmid15241506">{{cite journal |vauthors=Hammer F, Arlt W |title=[Hypopituitarism] |language=German |journal=Internist (Berl) |volume=45 |issue=7 |pages=795–811; quiz 812–3 |year=2004 |pmid=15241506 |doi=10.1007/s00108-004-1216-5 |url=}}</ref><ref name="pmid25712898">{{cite journal |vauthors=de Fost M, Oussaada SM, Endert E, Linthorst GE, Serlie MJ, Soeters MR, DeVries JH, Bisschop PH, Fliers E |title=The water deprivation test and a potential role for the arginine vasopressin precursor copeptin to differentiate diabetes insipidus from primary polydipsia |journal=Endocr Connect |volume=4 |issue=2 |pages=86–91 |year=2015 |pmid=25712898 |pmc=4401105 |doi=10.1530/EC-14-0113 |url=}}</ref>
 
{| style="border: 0px; font-size: 90%; margin: 3px; width: 1000px" align="center"
| valign="top" |
|+
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Differential Diagnosis}}
! style="background: #4479BA; width: 300px;" | {{fontcolor|#FFF|Similar Features}}
! style="background: #4479BA; width: 300px;" | {{fontcolor|#FFF|Differentiating Features}}
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |[[SIADH]]
| style="padding: 5px 5px; background: #F5F5F5;" |
*Excessive release of [[Vasopressin|antidiuretic hormone (ADH or vasopressin)]]  from the [[posterior pituitary]] gland or another source.
*[[Hyponatremia]]
*[[Fluid]] overload
*[[Hyponatremia]] <135 mmol/l
*Effective serum [[osmolality]] < 275 mOsm
*Urine [[sodium]] concentration > 40 mMol/l
*Plasma [[uric acid]] < 200
*Absence of [[edema]]-inducing diseases, such as [[heart failure]], [[liver cirrhosis]], and [[nephrotic syndrome]]
*Normal [[adrenal]] and [[thyroid]] function
| style="padding: 5px 5px; background: #F5F5F5;" |
* [[Weight loss]] (in case of [[malignancy]])
* History of head [[trauma]]
* History of medication intake
* Positive [[family history]]
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |[[Cerebral salt wasting syndrome]]
| style="padding: 5px 5px; background: #F5F5F5;" |
*[[Hyponatremia]]
*Urine [[sodium]] concentration > 40 mMol/l
 
| style="padding: 5px 5px; background: #F5F5F5;" |
*[[Hypovolemia]]
*Intracranial [[diseases]], such as:
**[[Tumor]]
**[[Trauma]]
**[[Hematoma]]
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |[[Adrenal insufficiency]]
| style="padding: 5px 5px; background: #F5F5F5;" |
*[[Hyponatremia]]
 
| style="padding: 5px 5px; background: #F5F5F5;" |
*[[Weight loss]]
*Sparse [[axillary]] hair
*[[Hyperpigmentation]]
*[[Orthostatic hypotension]]
*[[Fever]]
*[[Hypotension]]
*[[Eosinophilia]]
*[[Hyperkalemia]]
*[[Hypoglycemia]]
*Morning low plasma [[cortisol]]
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |[[Hypopituitarism]]
| style="padding: 5px 5px; background: #F5F5F5;" |
*[[Hyponatremia]]
| style="padding: 5px 5px; background: #F5F5F5;" |
* [[Fatigue]]
* [[Weight loss]]
* Decreased [[libido]]
* Decreased [[appetite]]
* Facial [[puffiness]]
* [[Anemia]]
* [[Infertility]]
* [[Cold intolerance]]
* [[Amenorrhea]]
* Inability to lactate in [[breast feeding]] women
* Decreased [[facial]] or [[body hair]] in men
* [[Short stature]] in children
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |[[Psychogenic polydipsia]]
| style="padding: 5px 5px; background: #F5F5F5;" |
*[[Fluid]] overload
*[[Hyponatremia]]
| style="padding: 5px 5px; background: #F5F5F5;" |
*Defect in the [[hypothalamus]]
*[[Polyuria]]
*[[Polydipsia]]
*[[Confusion]]
*[[Lethargy]]
*[[Psychosis]]
*[[Seizures]]
|}
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
[[Category:Needs content]]


[[Category:Medicine]]
[[Category:Endocrinology]]
[[Category:Endocrinology]]
[[Category:Neurosurgery]]
[[Category:Syndromes]]
[[Category:Nephrology]]
[[Category:Nephrology]]
 
[[Category:Neurology]]
{{WikiDoc Help Menu}}
[[Category:Up-To-Date]]
{{WikiDoc Sources}}

Latest revision as of 00:22, 30 July 2020

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

Overview

Syndrome of inappropriate antidiuretic hormone (SIADH) must be differentiated from other causes of hyponatremia, such as cerebral salt wasting syndrome, adrenal insufficiency, hypopituitarism, and psychogenic polydipsia.

Differentiating Syndrome of Inappropriate Antidiuretic Hormone from other Diseases

SIADH must be differentiated from cerebral salt wasting, adrenal insufficiency, hypopituitarism, hypothyroidism, and psychogenic polydipsia.[1][2][3]

Differential Diagnosis Similar Features Differentiating Features
SIADH
Cerebral salt wasting syndrome
Adrenal insufficiency
Hypopituitarism
Psychogenic polydipsia

References

  1. Heidelbaugh JJ (2016). "Endocrinology Update: Hypopituitarism". FP Essent. 451: 25–30. PMID 27936532.
  2. Hammer F, Arlt W (2004). "[Hypopituitarism]". Internist (Berl) (in German). 45 (7): 795–811, quiz 812–3. doi:10.1007/s00108-004-1216-5. PMID 15241506.
  3. de Fost M, Oussaada SM, Endert E, Linthorst GE, Serlie MJ, Soeters MR, DeVries JH, Bisschop PH, Fliers E (2015). "The water deprivation test and a potential role for the arginine vasopressin precursor copeptin to differentiate diabetes insipidus from primary polydipsia". Endocr Connect. 4 (2): 86–91. doi:10.1530/EC-14-0113. PMC 4401105. PMID 25712898.