Endocrine disorders: Syndrome Of Inappropriate ADH

Question 1

What electrolyte abnormality would you expect to find in patients with suspected SIADH, syndrome of inappropriate ADH? Why?

Answer 1

Hyponatremia, as a result of the excess of ADH being produced by the neurophysis

Question 2

What are some common differentials for hyponatremia?

Answer 2

CHF, nephrosis, severe liver disease, hyperglycemia, and hyperlipidemia

Question 3

How can syndrome of increased ADH be differentiated from primary hypoadrenocorticism?

Answer 3

Primary hypoadrenocorticism is associated with azotemia and hyperkalemia

Question 4

In acute cases, emergency treatment includes -?

Answer 4

Fluid therapy (hypertonic saline given slowly over 2-4 hrs), potassium supplementation, and furosemide (if hypertonic saline is used) to inhibit water resorption and reduce volume overload