What is SIADH?

 

SIADH is the syndrome of inappropriate antidiuretic hormone. In this disease, the body makes too much antidiuretic hormone (ADH) [1]. The antidiuretic hormone helps the kidney to regulate the amount of water in the body. It helps the body to conserve and eliminate water according to the body's needs.

 

SIADH can occur due to problems in the brain and other triggers such as asthma and infections. As a result, the body retains a large amount of water in the body. The sodium levels in the body also decrease. Hyponatremia is responsible symptoms such as irritability, nausea,  vomiting, and headaches. If left untreated it can progress to respiratory failure, coma, and death.

 

 

 

What are the Symptoms of SIADH?

 

The symptoms of SIADH depend on the status of hyponatremia. The history of the patient should take into account the following: [2]

• If slowly progressive hyponatremia is associated with fever
• If there is Chronic Pain
• Symptoms from CNS such as trouble with memory, stroke, hemorrhage, infection, mental illness and psychosis. [3]

 

The following symptoms are associated with severe or rapid-onset hyponatremia:

• Confusion
• Disorientation
• Delirium
• Generalized muscle weakness
• Myoclonus
• Tremor
• Hyporeflexia
• Asterixis
• Ataxia
• Dysarthria
• Pathologic Reflexes
• Cheyne-Stokes Respiration
• Generalized Seizures
• Coma

 

 

 

What are the Causes of SIADH?

 

The main cause of the syndrome of inappropriate antidiuretic hormone is excess production of ADH. It may be due to the following reasons: [3]

 

• Medicines that are used to treat seizures, cancer, antidepressants drugs, opiates, anti-diabetic and anti-hypertensive medicines
• Brain disorders, injury, infection, or stroke
• Meningitis
• Bleeding in or around the brain
• Hydrocephalus
• Guillain-Barre syndrome (a condition in which the immune system attacks the nerves)
• Multiple sclerosis
• Generalized infections such as HIV and Rocky Mountain Spotted Fever
• Asthma
• Surgery under general anesthesia
• Hypothalamus injury
• Tuberculosis
• Cancer
• Chronic Infection
• Lung Diseases
• Pneumonia
• Cystic Fibrosis
• Sarcoidosis
• Substance use disorder
• Rare diseases of the hypothalamus and pituitary
• Leukemia
• Cancer of the small intestine, pancreas, and brain
• Mental Disorders
• Hereditary Diseases

 

 

 

What are the Treatment Options for SIADH?

The treatment options for SIADH depend on your age, health, medical history, extent of symptoms of SIADH, and your ability to manage the stress of medications, procedures, and therapies.

 

To prevent excess fluid buildup in your body, the Doctor will limit your fluid intake. Limiting fluid intake means limiting water, and most beverages including tea, coffee, soda, and juices.

 

Chronic SIADH is treated according to the underlying cause. The treatment options are

• Medications to inhibit ADH
• Medications to maintain body fluids
• Surgery to remove the tumor

 

 

 

References:

1. https://www.medicinenet.com/what_causes_siadh/article.htm
2. https://emedicine.medscape.com/article/246650-overview
3. https://www.ncbi.nlm.nih.gov/books/NBK507777/
4. https://medlineplus.gov/ency/article/000314.htm#:~:text=Syndrome%20of%20inappropriate%20antidiuretic%20hormone%20secretion%20(SIADH)%20is%20a%20condition,to%20retain%20too%20much%20water.
5. https://www.webmd.com/a-to-z-guides/what-is-siadh

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