A case of SIADH associated with carcinoma of the ampulla of Vater / 대한내과학회지

ABSTRACT

The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is one of the most common causes of hyponatremia and results from inappropriate release of antidiuretic hormone (ADH). SIADH may be caused by a variety of malignant tumors, including central nervous system disorders, intrathoracic disorders and various pharmacologic agents. We experienced a case of SIADH associated with carcinoma of the ampulla of Vater. A 73-year-old man was admitted to hospital with abdominal pain and hiccup. Laboratory findings showed that the serum sodium concentration and serum osmolarity were extremely low, while the urine sodium concentration and urine osmolarity were inappropriately high, and the patient was diagnosed with SIADH. Endoscopy showed an ill-defined nodular ampulla of Vater and a biopsy revealed a carcinoma. Resection of the ampullary carcinoma corrected the abnormal sodium levels and restored the laboratory findings to normal. The normal conditions have been continuous for 6 months. To our knowledge, this is the first case of SIADH caused by an ampullary carcinoma.