Sandbox:Vindhya

Medical and Neurologic causes

Neurologic disorders	Cerebral neoplasms, cerebral trauma and post concussive syndromes ,Cerebrovascular disease, subarachnoid hemorrhage, Migraine, encephalitis,cerebral syphilis, Multiple sclerosis,Wilsons disease,Huntington disease,Epilepsy
Endocrine disorder	Pituitary dysfunction, Thyroid dysfunction, parathyroid dysfunction, Adrenal dysfunction,pheochromocytoma
Systemic conditions	Hypoxia, Cardiovascular disease, pulmonary insufficiency, anemia
Inflammatory disorders	Lupus erythematosus, rheumatoid arthritis, polyarteritis nodosa, temporal arteritis
Deficiency states	Vitamin B12 deficiency, pellagra
Miscellaneous	hypoglycemia, carcinoid syndrome, uremia, premenstrual syndrome, porphyria
Substances	Caffeine,cannabis,Hallucinogens, theophylline, amphetamines,yohimbine,sympathomimetics, mercury, Arsenic,organophosphates,benzene
Withdrawal	alcohol,caffeine, opiods,antihypertensives

siadh classification

Classification

• Acute setting (<48 hours since onset) where moderate symptoms are noted, treatment options for hyponatremia include the following:
• 3% hypertonic saline (513 mEq/L)
• Loop diuretics with saline
• Vasopressin-2 receptor antagonists (aquaretics, such as conivaptan or tolvaptan)
• Water restriction

• In chronic asymptomatic setting, the treatment is as follows:
• Fluid restriction
• Vasopressin-2 receptor antagonists
• Other agents to be considered include loop diuretics with increased salt intake, urea, and demeclocycline

• Raise serum sodium by 0.5-1 mEq/hr, and not more than 10-12 mEq in the first 24 hours,to avoid complications like Osmotic demyelination syndrome.

• In rare medical emergencies more commonly seen in cardiology in the context of hypervolemic severe hyponatremia rather than in SIADH :
• Continuous veno-venous hemofiltration (CVVH)
• Slow, low-efficiency daily dialysis (SLEDD have been used to improve hyponatremia. These methods are invasive so their use is very limited.