Paroxetine is a well-known selective serotonin reuptake inhibitor, and has been reported to be advantageous for chronic pain control. Paroxetine is increasingly used for various types of chronic pain because of its safety; however, hyponatremia, or syndrome of inappropriate secretion of antidiuretic hormone (SIADH) associated with paroxetine, has been reported. This complication is relatively rare, but some patients have presented with severe neurological symptoms. Here, we report the first case of SIADH associated with paroxetine in Korea.
Chronic Pain ; Humans ; Hyponatremia ; Inappropriate ADH Syndrome ; Korea ; Paroxetine ; Serotonin

To summarize and analyze the causes of hyponatremia in patients with brucellosis and explore the clinical manifestations of syndrome of inappropriate antidiuresis(SIAD)in patients with brucellosis. The clinical data of 111 patients with acute brucellosis who were treated in Peking Union Medical College Hospital from September 2011 to December 2017 were retrospectively reviewed.Hyponatremia was defined by serum sodium level lower than 135 mmol/L.Clinical characteristics including medical histories,vital signs,and laboratory test findings were collected and analyzed. Hyponatremia was found in 14(12.6%)of 111 patients with brucellosis,among whom 3 patients were confirmed to be with SIAD,10 were suspected as SIAD,and 1 was diagnosis as hypopituitarism.Hypoalbuminemia,elevation of erythrocyte sedimentation rate,and high sensitivity C reactive protein were found in brucellosis patients with SIAD,along with severe complications such as infective endocarditis,septic shock,and anemia. Hyponatremia is not a rare condition in brucellosis patients and may be caused by SIAD.
Brucellosis ; Humans ; Hyponatremia ; Inappropriate ADH Syndrome ; Retrospective Studies

The authors report a case of cerebral salt wasting(CSW) syndrome followed by diabetes insipidus and meningitis after transsphenoidal approach for pituitary adenoma. Fluid and electrolyte imbalance occurs occasionally in neurosurgical patients due to DI or SIADH, however, CSW is different disease entity and the methods of treatment are different from those of DI or SIADH. A number of studies in recent years have shown that hyponatremia in many patients with intracranial disease might actually be caused by CSW in which a renal loss of sodium leads to hyponatremia and massive urinary water loss. CSW of this patient was resolved by fluid and salt replacement after 6 months.
Diabetes Insipidus ; Humans ; Hyponatremia ; Inappropriate ADH Syndrome ; Meningitis* ; Meningitis, Bacterial ; Pituitary Neoplasms* ; Pseudomonas* ; Sodium ; Wasting Syndrome*

Neuromyelitis optica spectrum disorder (NMOSD) may present with area postrema syndrome, which is characterized by intractable vomiting and hiccups. Hyponatremia is common in NMOSD and is mostly associated with the syndrome of inappropriate antidiuretic hormone secretion (SIADH). In contrast to SIADH, cerebral salt wasting syndrome (CSWS) causes hyponatremia, which is associated with severe natriuresis and extracellular volume depletion in patients with cerebral disease. To our knowledge, hyponatremia associated with CSWS has not been reported in a patient with NMOSD. Here, we describe a NMOSD presenting with hyponatremia, which may be caused by CSWS following area postrema syndrome.
Area Postrema ; Hiccup ; Humans ; Hyponatremia ; Inappropriate ADH Syndrome ; Natriuresis ; Neuromyelitis Optica* ; Vomiting ; Wasting Syndrome*

The most common cause of hyponatremia in hospitalized patients is syndrome of inappropriate antidiuretic hormone secretion (SIADH) characterized by water retention leading to decreased serum sodium concentration and osmolality. Since the report of Schwartz and his co-workers1), this syndrome has been described in various clinical settings. There are some reports on SIADH associated with Guillain-Barre syndrome in the literature2-6). However, to our knowledge, there was only one reported case of SIADH associated with Guillain-Barre syndrome in Korea
Guillain-Barre Syndrome* ; Humans ; Hyponatremia ; Inappropriate ADH Syndrome* ; Korea ; Osmolar Concentration ; Sodium ; Water

Although hyponatremia is a common electrolyte disorder, its evaluation and management are not well defined. When diagnosed, hyponatremia should be categorized based on four criteria: volume status, urinary Na+, serum K+, and acid-base balance. This approach helps to determine what the cause of hyponatremia is and how it should be treated. Initially, hypovolemic hyponatremia, including cerebral salt wasting syndrome (CSWS), is treated by volume resuscitation and salt supplementation. Euvolemic hyponatremia, including the syndrome of inappropriate secretion of antidiuretic hormone (SIADH), is treated by fluid restriction and salt supplementation, and hypervolemic hyponatremia is treated by fluid restriction and salt restriction. Hyponatremia can be managed well using these primary treatments and medications.
Acid-Base Equilibrium ; Hyponatremia ; Hypovolemia ; Inappropriate ADH Syndrome ; Resuscitation ; Wasting Syndrome

A 54-year-old man was diagnosed as syndrome of inappropriate secretion of antidiuretic hormone (SIADH) 7 days after lung transplantation, whereas the preoperative serum sodium level was normal. Hypertonic saline infusion with furosemide did not improve hyponatremia, however, tolvaptan corrected his serum sodium levels from 123 mEq/L to 131 mEq/L. Seven days after maintenance of tolvaptan, this drug was discontinued and hyponatremia did not occur. Herein, we report a case of SIADH after lung transplantation treated with tolvaptan.
Furosemide ; Humans ; Hyponatremia ; Inappropriate ADH Syndrome ; Lung Transplantation* ; Middle Aged ; Sodium

Bougienation is generally an effective method providing temporary relief of obstruction to facilitate stent insertion in patients with malignant esophageal stricture. The complicated by after bougienation such as esophageal perforation, mediastinitis, bronchoesophageal fistula, pneumomediastinum, pneumothorax were reported. However, syndrome of inappropriate antidiuretic hormone secretion (SIADH) complicated by bougienation has rarely been reported. Thus, we report a case of SIADH and pneumomediastinum complicated by bougienation in a patient with malignant esophageal stricture.
Esophageal Perforation ; Esophageal Stenosis* ; Fistula ; Humans ; Inappropriate ADH Syndrome ; Mediastinal Emphysema* ; Mediastinitis ; Pneumothorax ; Stents

In hyponatremic patients, the assessment of extracellular fluid volume plays an essential step in diagnosing the etiology of hyponatremia and deciding how to manage it. Although various laboratory tests and diagnostic procedures have been developed for differential diagnosis of hyponatremia, there still are limits to the evaluation of the status of extracellular fluid volume due to the data that overlaps each other, leading to the difficulty in diagnosing between euvolemia and hypovolemia. Also, there is no consensus about how to guide the type and amount of fluid therapy despite many formulas including Adrogue-Madias and Barsoum-Levine formulas have been suggested. Hereby, we are reporting two hyponatremic patients (102 and 105 mEq/L) admitted simultaneously with indistinct volume status on initial clinical and laboratory examinations, but were clarified as euvolemic hyponatremia (syndrome of inappropriate antidiuretic hormone secretion) in one and hypovolemic hyponatremia in the other case after sequential intravenous saline (2 L over 24 hrs) and oral water (20 mL/kg) loading tests. When serum sodium values calculated by the above-mentioned two formulas were compared with actually measured ones during saline loading test in these cases, the Barsoum-Levine formula revealed almost no discrepancy between both the values while the Adrogue-Madias formula underestimated the measured value.
Consensus ; Diagnosis, Differential ; Extracellular Fluid ; Fluid Therapy ; Humans ; Hyponatremia ; Hypovolemia ; Inappropriate ADH Syndrome ; Sodium ; Water

The syndrome of inappropriate secretion of antidiuretic hormone (SIADH) has been reported in a great variety of diseases and disorders of central nervous system (CNS). However, there has been only 7 cases of SLE reports in association with SIADH and correlation of SIADH and SLE has not been clearly demonstrated. Previous cases showed improvement of SIADH as lupus activity resolved during treatment. We report a case of SLE in association with SIADH which showed improvement during treatment with prednisolone and cyclophosphamide.
Central Nervous System ; Cyclophosphamide ; Humans ; Inappropriate ADH Syndrome ; Lupus Erythematosus, Systemic* ; Prednisolone