HYPONATREMIA-SIADH

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SUMMARY

1. Barrter and Schwartz describe the following criteria for the diagnosis of SIADH:[1]
2. Peri A, Pirozzi N, Parenti G, Festuccia F, Menè P. Hyponatraemia and the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). J Endocrinol Invest 2010;33(9):671–82.
3. Pillai BP, Umnikrishnan AG, Pavithran PV. Syndrome of inappropriate antidiuretic hormone secretion: Revisiting a classical endocrine disorder. Indian J Endocrinol Metab 2011;15(Suppl 3):S208–15.
[2][3]

A. Decreased serum osmolality (< 275 mOsm/kg) B. Increased urine osmolality (> 100 mOsm/kg)
C. Increased urine sodium (> 20 mmol/L)
D. Euvolaemia
E. No other cause for hyponatremia (diuretics, hypothyroidism, cortisol deficiency, hyperproteinemia, hyperlipidaemia, hyperglycaemia)

2. The mechanism for ADH release in hypothyroidism is decreased cardiac output, which stimulates the carotid baroreceptors.

3. Rule out hypothyroid­ism and glucocorticoid deficiency in all patients with normovolemic hyponatremia before making a diagnosis of SIADH.


Reference(s)

  1. Shannon, G. Severe hyponatraemia – Recognition and management. Aust Presc 2011;34:42–45.
  2. Peri A, Pirozzi N, Parenti G, Festuccia F, Menè P. Hyponatraemia and the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). J Endocrinol Invest 2010;33(9):671–82.
  3. Pillai BP, Umnikrishnan AG, Pavithran PV. Syndrome of inappropriate antidiuretic hormone secretion: Revisiting a classical endocrine disorder. Indian J Endocrinol Metab 2011;15(Suppl 3):S208–15.


Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].