Syndrome of inappropriate antidiuretic hormone differential diagnosis: Difference between revisions

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Revision as of 19:50, 11 October 2017

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [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	Excessive release of 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	-
Cerebral salt wasting syndrome	Hyponatremia Urine sodium concentration > 40 mMol/l	Hypovolemia Intracranial diseases, such as: Tumor Trauma Hematoma
Adrenal insufficiency	Hyponatremia	Weight loss Sparse axillary hair Hyperpigmentation Orthostatic hypotension Fever Hypotension Eosinophilia Hyperkalemia Hypoglycemia Morning low plasma cortisol
Hypopituitarism	Hyponatremia	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
Psychogenic polydipsia	Fluid overload Hyponatremia	Defect in the hypothalamus Polyuria Polydipsia Confusion Lethargy Psychosis Seizures

References

↑ Heidelbaugh JJ (2016). "Endocrinology Update: Hypopituitarism". FP Essent. 451: 25–30. PMID 27936532.
↑ 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.
↑ 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.

Template:WikiDoc Sources

[pmid27936532-1] Heidelbaugh JJ (2016). "Endocrinology Update: Hypopituitarism". FP Essent. 451: 25–30. PMID 27936532.

[pmid15241506-2] 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.

[pmid25712898-3] 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.

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@@ Line 1: / Line 1: @@
 __NOTOC__
 {{Syndrome of inappropriate antidiuretic hormone}}
-{{CMG}}; {{AE}} {{Vbe}}
+{{CMG}}; {{AE}}{{EG}}
 ==Overview==
-[[SIADH| Syndrome of inappropriate antidiuretic hormone]] consists of [[hyponatremia]], inappropriately elevated urine [[osmolality]], excessive urine [[sodium]], and decreased serum [[osmolality]] in a [[euvolemic]] patient without [[edema]]. These findings should occur in the absence of [[diuretic]] treatment with normal [[cardiac]], [[renal]], [[adrenal]], [[hepatic]], and [[Thyroid|thyroid function]]. [[Hyponatremia]] occurs in about 30% of hospitalized patients and [[SIADH]] is the most frequent cause of [[hyponatremia]]. Differentiating SIADH from other causes of [[hyponatremia]] becomes essential to evaluate the treatment plan.
+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==
 [[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>
@@ Line 32: / Line 31: @@
 | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"|[[Cerebral salt wasting syndrome]]
 | style="padding: 5px 5px; background: #F5F5F5;"|
-*[[Hypovolemia]]
 *[[Hyponatremia]]
+*Urine [[sodium]] concentration > 40 mMol/l
 | style="padding: 5px 5px; background: #F5F5F5;"|
+*[[Hypovolemia]]
 *Intracranial [[diseases]], such as:
 **[[Tumor]]
@@ Line 42: / Line 43: @@
 | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"|[[Adrenal insufficiency]]
 | style="padding: 5px 5px; background: #F5F5F5;"|
-*[[Hypovolemia]]
 *[[Hyponatremia]]
 | style="padding: 5px 5px; background: #F5F5F5;"|
 *[[Weight loss]]
@@ Line 58: / Line 59: @@
 | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"|[[Hypopituitarism]]
 | style="padding: 5px 5px; background: #F5F5F5;"|
-*[[Hypovolemia]]
 *[[Hyponatremia]]
 | style="padding: 5px 5px; background: #F5F5F5;"|
@@ Line 76: / Line 76: @@
 | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"|[[Psychogenic polydipsia]]
 | style="padding: 5px 5px; background: #F5F5F5;"|
-*[[Hypovolemia]]
+*[[Fluid]] overload
 *[[Hyponatremia]]
 | style="padding: 5px 5px; background: #F5F5F5;"|
@@ Line 91: / Line 91: @@
 {{Reflist|2}}
-[[Category:Needs content]]
 [[Category:Endocrinology]]
 [[Category:Neurology]]

Syndrome of inappropriate antidiuretic hormone differential diagnosis: Difference between revisions

Revision as of 19:50, 11 October 2017

Overview

Differentiating Syndrome of Inappropriate Antidiuretic Hormone from other Diseases

References

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