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Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is a condition in which the body makes too much antidiuretic hormone (ADH). This hormone helps the kidneys control the amount of water your body loses through the urine. SIADH causes the body to retain too much water.

Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is characterized by excessive unsuppressible release of antidiuretic hormone (ADH) either from the posterior pituitary gland, or an abnormal non-pituitary source. Unsuppressed ADH causes an unrelenting increase in solute-free water being returned by the tubules of the kidney to the venous circulation.

Treatment

Treatment depends on the cause of the problem. For example, surgery is done to remove a tumor producing ADH. Or, if a medicine is the cause, its dosage may be changed or another medicine may be tried.

In all cases, the first step is to limit fluid intake. This helps prevent excess fluid from building up in the body. Your provider will tell you what your total daily fluid intake should be.

Medicines may be needed to block the effects of ADH on the kidneys so that excess water is excreted by the kidneys. These medicines may be given as pills or as injections given into the veins (intravenous).

What causes SIADH?

SIADH tends to occur in people with heart failure or people with a diseased hypothalamus (the part of the brain that works directly with the pituitary gland to produce hormones). In other cases, a certain cancer (elsewhere in the body) may produce the antidiuretic hormone, especially certain lung cancers. Other causes may include the following:

  • Meningitis (inflammation of the meninges, the membranes that cover the brain and spinal cord)

  • Encephalitis (inflammation of the brain)

  • Brain tumors

  • Psychosis

  • Lung diseases

  • Head trauma

  • Guillain-BarrĂ© syndrome (a reversible condition that affects the nerves in the body. GBS can result in muscle weakness, pain, and even temporary paralysis of the facial, chest, and leg muscles. Paralysis of the chest muscles can lead to breathing problems.)

  • Certain medications

  • Damage to the hypothalamus or pituitary gland during surgery

  • Thyroid or parathyroid hormone deficiencies

  • HIV

  • Hereditary causes

What are the symptoms of SIADH?

Each person may experience symptoms differently. Symptoms, in more severe cases of SIADH, may include:

  • Nausea or vomiting

  • Cramps or tremors

  • Depressed mood,memory impairment

  • Irritability

  • Personality changes, such as combativeness, confusion, and hallucinations

  • Seizures

  • Stupor or coma

The symptoms of SIADH may resemble other problems or medical conditions. Always consult your child's doctor for a diagnosis.

How is SIADH diagnosed?

In addition to a complete medical history and physical examination, to confirm diagnosis of SIADH, blood and urine tests will need to be performed to measure sodium, potassium, and osmolality (concentration of solution in the blood and urine).

Treatment for SIADH

Specific treatment for SIADH will be determined by your doctor based on:

  • Your age, overall health, and medical history

  • Extent of the disease

  • Your tolerance for specific medications, procedures, or therapies

  • Expectations for the course of the disease

  • Your opinion or preference

The most commonly prescribed treatment for SIADH is fluid and water restriction. If the condition is chronic, fluid restriction may need to be permanent. Treatment may also include:

  • Certain medications that inhibit the action of ADH (also called vasopressin)

  • Surgical removal of a tumor that is producing ADH

  • Other medicines to help regulate body fluid volume

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