Antidiuretic hormone secretion

In addition, several other organs, like the heart, ovaty, amnion, chorion, decidua, testis, epididymis and prostate, have been reported to synthesize OT, suggesting a paracrine role for this hormone in these tissues. Ectopic AVP production by lung cancer cells or other neoplasms has been described in humans, leading to the syndrome of inappropriate antidiuretic hormone secretion. 

Satchell SC, Connaughton M Inappropriate antidiuretic hormone secretion and extreme rises in serum creatinine kinase following MDMA ingestion. Br J Hosp Med 51 495, 1994... 

Oxcarbazepine Hyponatremia (serum sodium concentrations less than 125 mEq/L) has been reported and occurs more frequently during the first 3 months of therapy serum sodium concentrations should be monitored in patients receiving drugs that lower serum sodium concentrations (e.g., diuretics or drugs that cause inappropriate antidiuretic hormone secretion) or in patients with symptoms of hyponatremia (e.g., confusion, headache, lethargy, and malaise). Hypersensitivity reactions have occurred in approximately 25-30% of patients with a history of carbamazepine hypersensitivity and requires immediate discontinuation. 

Antidiuretic hormone promotes the reabsorption of water from the tubules of the kidney, or antidiuresis. Specifically, it acts on the collecting ducts and increases the number of water channels, which increases the diffusion coefficient for water. This results in the body s conservation of water and the production of a low volume of concentrated urine. The reabsorbed water affects plasma osmolarity and blood volume. This effect of ADH on the kidney occurs at relatively low concentrations. At higher concentrations, ADH causes constriction of arterioles, which serves to increase blood pressure. Antidiuretic hormone secretion is regulated by several factors ... 

Paraneoplastic syndromes commonly associated with lung cancers include cachexia, hypercalcemia, syndrome of inappropriate antidiuretic hormone secretion, and Cushing s syndrome. 

Because of sensory neuropathy, deep pain is often experienced by patients given vincristine. Through involvement of the glossopharyngeal nerve, throat pain may occur, as may deep pain of almost any other area of the body (31,32). Neuropathic changes are not always peripheral. Hallucinations and overall mental status changes, such as depression and/or psychosis, are also rarely reported (31,32). Another CNS effect is the syndrome of inappropriate antidiuretic hormone secretion, which is a well-characterized side effect of vincristine (31,32). 

Abbreviations CNS, central nervous system COX, cyclooxygenase Gl, gastrointestinal NSAlDs, nonsteroidal anti-inflammatory drugs SIADH, syndrome of inappropriate antidiuretic hormone secretion. From Pick DM, Cooper IW, Wade WE, et al Updating the Beers criteria for potentially inappropriate medication use in older adults Results of a U.S. consensus panel of experts. Arch Intern Med 2003 163 2716. 

The syndrome of inappropriate antidiuretic hormone secretion, with resultant hyponatremia, may be induced by carbamazepine treatment. Alcoholic patients may be at greater risk for hyponatremia. 

Volume depletion of some degree occurs with all diuretics following prolonged use. This can cause problems, such as postural hypotension, in those with poor cardiac function. Volume depletion also causes a fall in glomerular filtration that can trigger homeostatic reflexes such as increased aldosterone and antidiuretic hormone secretion. This contributes to electrolyte disturbances, such as hypokalaemia and metabolic alkalosis. 

An 87-year-old woman received intra-articular betamethasone (Diprophos) 7 mg on three occasions for painful knee joints over 6 months. Six weeks after the last injection she developed diffuse pain and contractures in the legs, fatigue, nausea, abdominal pain, and weight loss of 6 kg. Both knee joints were tender but there was no effusion. Her serum sodium concentration was 123 mmol/1, serum osmolality 254 mosmol/kg, urine sodium 136 mmol/1, and urinary osmolality 373 mosmol/kg. The syndrome of inappropriate antidiuretic hormone secretion was diagnosed, but despite treatment she remained drowsy and hyponatremic. About a week later, she developed hypotension and symptoms of an acute abdomen. Further investigations showed that her basal cortisol concentration was low (36 nmol/1) but it increased to 481 nmol/1 after a short tetracosactide test, consistent with acute adrenal crisis. She recovered rapidly after treatment with oral hydrocortisone, but still required glucocorticoid substitution several months later. 

In an unusual case reported in detail from Saudi Arabia, a 28-year-old woman receiving gonadotropins developed acute respiratory distress, abdominal pain, and severe hyponatremia associated with the syndrome of inappropriate antidiuretic hormone secretion (SIADH) (19). A multiple pregnancy nevertheless resulted and three fetuses went to term successfully. 

Chan TY. Drug-induced syndrome of inappropriate antidiuretic hormone secretion. Causes, diagnosis and management. Drugs Aging 1997 11(1) 27—44. 

Furosemide rarely causes the syndrome of inappropriate antidiuretic hormone secretion (SIADH) (although it has been found useful in treating some patients with SIADH who cannot tolerate water restriction (428)). In furosemide-induced cases (SEDA-7, 246), serum ADH concentrations were raised, total body sodium was normal, total body potassium greatly reduced, and intracellular water raised at the expense of extracellular fluid volume. However, such cases are rare, and no new cases have been published since this complication was reported in SEDA-7. 

A syndrome resembling inappropriate antidiuretic hormone secretion has been described in a few patients receiving high-dose interferon alfa (SED-13,1093) (497). 

The Division of Drug Experience of the US Department of Health and Welfare issued a note on five cases of the syndrome of inappropriate antidiuretic hormone secretion and drugs to which it has been attributed (1137). All involved drugs with a tricyclic structure one patient was taking imipramine, three carbamazepine, and the others the closely related muscle relaxant cyclobenz-aprine. The dosage of imipramine was 50 mg/day for 3 weeks and the patient was a 72-year-old woman. Other cases have been reported, involving amitriptyline (1137), imipramine, and protriptyline (SEDA-17,17). 

Ikegami H, Shiga T, Tsushima T, Nirei T, Kasanuki H. Syndrome of inappropriate antidiuretic hormone secretion (SIADH) induced by amiodarone a report on two cases. J Cardiovasc Pharmacol Ther 2002 7(l) 25-8. 

Aslam MK, Gnaim C, Kutnick J, Kowal RC, McGuire DK. Syndrome of inappropriate antidiuretic hormone secretion induced by amiodarone therapy. Pacing Clin Electrophysiol 2004 27(6 Pt l) 831-2. 

Castrillon JL, Mediavilla A, Mendez MA, Cavada E, Carrascosa M, Valle R. Syndrome of inappropriate antidiuretic hormone secretion (SIADH) and enalapril. J Intern Med 1993 233(1) 89-91. 

Shaikh ZH, Taylor HC, Maroo PV, Llerena LA. Syndrome of inappropriate antidiuretic hormone secretion associated with lisinopril. Ann Pharmacother 2000 34(2) 176-9. 

Cubbin SA, Ah IM. Inappropriate antidiuretic hormone secretion associated with zopiclone. Psychiatr Bull 1999 23 306-7. 

Hyponatremia is caused by an excess of total body water relative to total body sodium and can result from a number of underlying conditions, including the syndrome of inappropriate antidiuretic hormone secretion (SIADH), cirrhosis, and congestive heart failure (CHF). In each of these conditions, inappropriate production of arginine vasopressin (AVP) [also known as vasopressin or antidiuretic hormone (ADH)], a neurohormone that regulates renal electrolyte-free water reabsorption, contributes to enhanced renal water retention, leading to decreased serum sodium concentrations.7 Hyponatremia can be characterized as hypervolemic, euvolemic, or hypovolemic... 

Zullino D, Brauchli S, Horvath A, Baumann P. Inappropriate antidiuretic hormone secretion and rhabdo-myolysis associated with citalopram. Therapie 2000 55(5) 651-2. 

Ajaelo I, Koenig K, Snoey E. Severe hyponatremia and inappropriate antidiuretic hormone secretion following ecstasy use. Acad Emerg Med 1998 5(8) 839-40. 

Gomez-Balaguer M, Pena H, Morillas C, Hernandez A. Syndrome of inappropriate antidiuretic hormone secretion and designer drugs (ecstasy). J Pediatr Endocrinol Metab 2000 13(4) 437-8. 

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