Abstract
The syndrome of inappropriate secretion of antidiuretic hormone (SIADH) is a common and multifactorial cause of hyponatremia that is often overlooked. The common pathophysiological mechanism is the increased production and/or action of antidiuretic hormone within the kidney, resulting in hypotonic hyponatremia. Inadequate correction of hyponatremia may have fatal neurological consequences leading to central pontine myelinolysis. We report the case of a patient with a history of recent head trauma, who came to our observation for acute-onset mental confusion secondary to severe hyponatremia due to SIADH of combined etiology.
MeSH terms
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Anti-Inflammatory Agents, Non-Steroidal / adverse effects
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Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
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Antidiuretic Hormone Receptor Antagonists
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Benzazepines / therapeutic use
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Brain Injuries / complications
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Confusion / etiology
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Humans
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Hyponatremia / drug therapy
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Hyponatremia / etiology*
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Inappropriate ADH Syndrome / complications*
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Inappropriate ADH Syndrome / physiopathology
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Kidney / physiopathology
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Male
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Middle Aged
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Multiple Trauma / complications
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Paraventricular Hypothalamic Nucleus / injuries
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Paraventricular Hypothalamic Nucleus / metabolism
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Psychomotor Agitation / etiology
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Rhabdomyolysis / complications
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Saline Solution, Hypertonic / therapeutic use
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Supraoptic Nucleus / injuries
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Supraoptic Nucleus / metabolism
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Tolvaptan
Substances
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Anti-Inflammatory Agents, Non-Steroidal
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Antidiuretic Hormone Receptor Antagonists
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Benzazepines
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Saline Solution, Hypertonic
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Tolvaptan