Syndrome of inappropriate antidiuretic hormone classification: Difference between revisions
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==Classification== | ==Classification== | ||
[[SIADH]] may be classified | [[SIADH]] may be classified into several sub-types based on the pattern of [[AVP|arginine vasopressin (AVP)]] [[secretion]] across a range of [[Plasma osmolality|plasma osmolalities]]:<ref name="pmid20164214">{{cite journal |vauthors=Hannon MJ, Thompson CJ |title=The syndrome of inappropriate antidiuretic hormone: prevalence, causes and consequences |journal=Eur. J. Endocrinol. |volume=162 Suppl 1 |issue= |pages=S5–12 |year=2010 |pmid=20164214 |doi=10.1530/EJE-09-1063 |url=}}</ref> | ||
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" | | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |TypeA | ||
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* Accounts for about 60-70% of [[SIADH]] | * Accounts for about 60-70% of [[SIADH]] | ||
*Excessive secretion of | *Excessive secretion of [[AVP]] is noted | ||
*Associated with [[lung cancer]] and nasopharyngeal tumors | *Associated with [[lung cancer]] and [[Nasopharyngeal Carcinoma|nasopharyngeal tumors]] | ||
* Patients are more susceptible to development of severe [[hyponatremia]] | * Patients are more susceptible to development of severe [[hyponatremia]] | ||
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*Accounts for (20–40%) of the cases | *Accounts for (20–40%) of the cases | ||
*Secretion of [[AVP]] occurs at lower [[plasma | *Secretion of [[AVP]] occurs at lower than normal [[Plasma osmolality|plasma osmolalities]] | ||
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" | | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Type C | ||
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* Failure to suppress AVP secretion at plasma osmolalities below the [[osmotic]] threshold | * Failure to suppress [[AVP]] secretion at [[Plasma osmolality|plasma osmolalities]] below the [[osmotic]] threshold | ||
* Occurs due to dysfunction of inhibitory neurons in the[[ hypothalamus]], leading to persistent low-grade basal AVP secretion | * Occurs due to dysfunction of [[inhibitory neurons]] in the [[hypothalamus]], leading to persistent low-grade basal [[AVP]] secretion | ||
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" | | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Type D | ||
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* Low or undetectable[[ AVP]] levels and circulating AVP response is not defective | * Low or undetectable [[AVP]] levels and circulating [[AVP]] response is not defective | ||
*Nephrogenic SIADH (NSIAD) may be attributed to this condition | *Nephrogenic [[SIADH]] (NSIAD) may be attributed to this condition | ||
* Associated with Gain-of-function[[ mutations]] in the V2 receptor leading to a clinical picture of SIADH, with undetectable AVP levels | *Associated with Gain-of-function [[mutations]] 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. | *The condition is inherited in an [[X-linked]] manner, although [[heterozygous]] females may have inappropriate antidiuresis of varying degrees. | ||
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Revision as of 15:10, 11 October 2017
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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 into several sub-types based on the pattern of arginine vasopressin (AVP) secretion across a range of plasma osmolalities:[1]
| Classification | Features |
|---|---|
| TypeA |
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| Type B |
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| Type C |
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| Type D |
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References
- ↑ Hannon MJ, Thompson CJ (2010). "The syndrome of inappropriate antidiuretic hormone: prevalence, causes and consequences". Eur. J. Endocrinol. 162 Suppl 1: S5–12. doi:10.1530/EJE-09-1063. PMID 20164214.