Syndrome of inappropriate antidiuretic hormone classification

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

Overview

SIADH may be classified into several sub-types based on the pattern of AVP (arginine vasopressin) secretion across a range of plasma osmolalities into type A, type B, type C and type D.

Classification

SIADH may be classified in to several sub-types based on the pattern ofAVPsecretion across a range of plasma osmolalities:

Classification	Features
TypeA	Accounts for about 60-70% of SIADH Excessive secretion of ADH is noted Associated with lung cancer and nasopharyngeal tumors Patients are more susceptible to development of severe hyponatremia
Type B	Accounts for (20–40%) of the cases Secretion of AVP occurs at lower plasma osmolalities than normal
TypeC	Failure to suppress AVP secretion at plasma osmolalities below the osmotic threshold Occurs due to dysfunction of inhibitory neurons in thehypothalamus, leading to persistent low-grade basal AVP secretion
Type D	Low or undetectableAVP levels and circulating AVP response is not defective Nephrogenic SIADH (NSIAD) may be attributed to this condition Associated with Gain-of-functionmutations in the V2 receptor leading to a clinical picture of SIADH, with undetectable AVP levels The condition is inherited in an X-linked manner,although heterozygous females may have inappropriate antidiuresis of varying degrees.