Syndrome of inappropriate ADH
From IDWiki
Background
Etiologies
- CNS: stroke, intracranial hemorrhage, infection, trauma, and psychosis
- Malignancy: ectopic ADH production by small cell carcinoma or, even more rarely, with other lung cancers, head-and-neck cancer, olfactory neuroblastoma, and extrapulmonary small cell carcinoma
- Medications: chlorpropamide, carbamazepine, oxcarbazepine, high-dose cyclophosphamide, SSRIs
- Others: vincristine, cinblastine, cinorelbine, cisplatin, thiothixene, thioridazine, haloperidol, amitriptyline, MAO inhibitors, melphalan, ifosfamide, methotrexate, opiates, NSAIDs, interferon alpha, interferon gamma, sodium valproate, bromocriptine, lorcainide, amiodarone, ciprofloxacin, high-dose imatinib, and ecstasy
- Surgery, likely mediated by pain, but also specifically after transsphenoidal pituitary surgery
- Lung disease: pneumonia, occasionally also with asthma, atelectasis, respiratory failure, and pneumothorax
- Endocrinopathies: hypopituitarism and hypothyroidism
- Also exogenous vasopressin, desmopressin, and oxytocin
- HIV
- Hereditary SIADH
- Idiopathy, more common in older patients though occasionally found later to be from occult malignancy
Differential Diagnosis
- Cerebral salt wasting, which mimics SIADH and is most commonly caused by subarachnoid hemorrhage
