Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) Associated with Mediastinal Schwannoma
Electrolytes & Blood Pressure
; : 42-46, 2017.
Article
em En
| WPRIM
| ID: wpr-149587
Biblioteca responsável:
WPRO
ABSTRACT
Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is the most common cause of euvolemic hypo-osmotic hyponatremia. There are several etiologies of SIADH including neuroendocrine tumor, pulmonary disease, infection, trauma, and medications. Here, we report a case of SIADH associated with a schwannoma involving the mediastinum in a 75-year-old woman who presented with nausea, vomiting, and general weakness. Laboratory testing showed hypo-osmolar hyponatremia, with a serum sodium level of 102mmol/L, serum osmolality of 221mOsm/kg, urine osmolality of 382mOsm/kg, urine sodium of 55 mmol/L, and plasma antidiuretic hormone (ADH) of 4.40 pg/mL. Chest computed tomography identified a 1.5-cm-sized solid enhancing nodule in the right lower paratracheal area. A biopsy specimen was obtained by video-assisted thoracoscopic surgery, which was diagnosed on pathology as a schwannoma. The hyponatremia was completely resolved after schwannoma resection and plasma ADH level decreased from 4.40 pg/mL to 0.86 pg/mL. This case highlights the importance of suspecting and identifying the underlying cause of SIADH when faced with refractory or recurrent hyponatremia, and that on possibility is mediastinal schwannoma
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Texto completo:
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Base de dados:
WPRIM
Assunto principal:
Concentração Osmolar
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Patologia
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Plasma
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Sódio
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Tórax
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Vômito
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Biópsia
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Tumores Neuroendócrinos
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Cirurgia Torácica Vídeoassistida
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Hiponatremia
Limite:
Aged
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Female
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Humans
Idioma:
En
Revista:
Electrolytes & Blood Pressure
Ano de publicação:
2017
Tipo de documento:
Article