Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) Associated with Mediastinal Schwannoma
Electrolytes & Blood Pressure
;
: 42-46, 2017.
Article
in English
| WPRIM
| ID: wpr-149587
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
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Osmolar Concentration
/
Pathology
/
Plasma
/
Sodium
/
Thorax
/
Vomiting
/
Biopsy
/
Neuroendocrine Tumors
/
Thoracic Surgery, Video-Assisted
/
Hyponatremia
Limits:
Aged
/
Female
/
Humans
Language:
English
Journal:
Electrolytes & Blood Pressure
Year:
2017
Type:
Article
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