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    "textoCompleto" => "<p class="elsevierStylePara">Dear Editor&#44;</p><p class="elsevierStylePara">Syndrome of inappropriate antidiuretic hormone hypersecretion &#40;SIADH&#41; should be suspected in patients with hypoosmolar hyponatraemia&#44; elevated urinary osmolality&#44; sodium concentration in urine above 40mEq&#47;l&#44; normal acid-base balance and blood potassium&#44; and a low concentration of uric acid in plasma&#46; Extracellular volume should be normal and the presence of kidney failure&#44; hypothyroidism&#44; cortisol deficiency and diuretic treatment should be ruled out&#46;<span class="elsevierStyleSup">1</span></p><p class="elsevierStylePara">Among the causes of SIADH&#44; those that are secondary to lung diseases have been described&#46;<span class="elsevierStyleSup">2-4</span> Possible mechanisms of induced vasopressin secretion are&#58; hypoxaemia and hypercapnia&#44; haemodynamic abnormalities&#44; alterations in the regulation and release of desmopressin caused by tumours&#44; different drugs and stress&#46;<span class="elsevierStyleSup">4</span></p><p class="elsevierStylePara">We would like to describe the case of a 68-year-old male patient who was taken to the Emergency Department because of diffuse abdominal pain and vomiting&#44; as well as alarming symptoms that included slow mental reactions and disorientation&#46; The patient had a history of chronic obstructive pulmonary disease caused by severe asthma treated chronically with oral corticosteroids&#44; non-insulin-dependent diabetes mellitus&#44; arterial hypertension and a transurethral resection of the bladder because of a neoplasia four years before&#46; The patient&#191;s usual treatment consisted of metformin&#44; simvastatin&#44; enalapril&#44; alendronic acid&#44; calcium carbonate&#44; omeprazol&#44; methylprednisone and inhaled bronchodilators&#46;</p><p class="elsevierStylePara">A blood test was carried out which revealed severe hyponatraemia 115mmol&#47;l with plasma hypoosmolality 243mOsm&#47;kg and hypouricaemia 2&#46;4mg&#47;dl&#44; with normal blood potassium and renal function&#46; There was elevated sodium loss in urine of 148mEq&#47;l&#46; The presence of hypothyroidism and adrenal failure was ruled out&#46; The patient appeared to present SIADH and so water was restricted and hypertonic intravenous saline solution was administered&#46; The patient&#191;s hyponatraemia progressively improved and his cognitive state normalised&#46; When searching for the cause of SIADH&#44; a brain MRI scan was carried out but no significant findings were made and a chest CT was performed which showed increased density of alveolar characteristics limited to basal segments of the right upper lobe that was very suggestive of pneumonia &#40;figure 1A&#41;&#46; However&#44; a chest x-ray had been carried out on admission that did not show significant changes with regard to previous tests &#40;figure 1B&#41;&#44; the respiratory auscultation was normal and there were no leukocytes or other values that indicated infection&#46; During admission the only significant symptom was an occasional fever of 37&#46;2-37&#46;4&#186; C&#46; Therefore&#44; oral levofloxacin treatment was started and six days later a new chest CT showed significant improvement in the pneumonia&#46; The urinary antigen tests for Legionella and Pneumococcus were negative&#46; Gradually&#44; the withdrawal of hypertonic saline solution was possible&#46; It was administered until discharge following 15 days in hospital with water restriction&#44; 6g per day of salt and 10mg&#47;day torsemide&#46; Plasma sodium levels remained stable at 131mmol&#47;l&#46; In the GP follow up&#44; salt and diuretics were withdrawn and a month after admission the patient had fully recovered from SIADH&#44; with plasma sodium levels 136mmol&#47;l&#46;</p><p class="elsevierStylePara">The following lung diseases have been described in the literature as potential inducers of SIADH&#58; pneumonias&#44; &#40;viral&#44; bacterial&#44; tuberculous&#44; mycotic&#41;&#44; pumonary abscesses&#44; asthma&#44; atelectasis&#44; pneumothorax and fibrocystic disease&#46;<span class="elsevierStyleSup">2-4</span> With regard to pulmonary tumours&#44; small cell carcinomas are most likely to be involved&#44; since induced SIADH is a paraneoplastic condition due to the ectopic secretion of vasopressin&#46;<span class="elsevierStyleSup">4</span> In the cases described&#44; the symptoms of pulmonary diseases stand out first and foremost&#46; In the case of our patient&#44; it is interesting that the aetiological study of SIADH led to the diagnosis of pneumonia after the chest CT was carried out&#46; Therefore we would like to highlight the importance of examining the lungs in cases of SIADH&#44; especially when dealing with immunodepressed patients who are generally treated with corticosteroids and whose symptoms of infection may be latent&#44; and thereby associated with very low clinical suspicion&#46; <br></br></p><p class="elsevierStylePara"><a href="grande&#47;43118078&#95;f1&#95;pag497&#46;jpg" class="elsevierStyleCrossRefs"><img src="43118078_f1_pag497.jpg"></img></a></p><p class="elsevierStylePara">Figure 1&#46; </p>"
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                  "referenciaCompleta" => "Anderson RJ. Hospital-associated hyponatremia. Kidney Int 1986;29:1237-47.  <a href="http://www.ncbi.nlm.nih.gov/pubmed/3747337" target="_blank">[Pubmed]</a>"
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Syndrome of inappropriate antidiuretic hormone hypersecretion caused by pneumonia diagnosed using a CT scan
Síndrome de secreción inadecuada de hormona antidiurética debido a neumonía diagnosticada por TAC
Montserrat Picazo Sáncheza, M.. Cuxart Péreza, R.. Sans Lormana, C.. Sardà Borroya
a Servicio de Nefrología, Fundació Salut Empordà. Hospital de Figueres, Figueres, Gerona, España,
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    "textoCompleto" => "<p class="elsevierStylePara">Dear Editor&#44;</p><p class="elsevierStylePara">Syndrome of inappropriate antidiuretic hormone hypersecretion &#40;SIADH&#41; should be suspected in patients with hypoosmolar hyponatraemia&#44; elevated urinary osmolality&#44; sodium concentration in urine above 40mEq&#47;l&#44; normal acid-base balance and blood potassium&#44; and a low concentration of uric acid in plasma&#46; Extracellular volume should be normal and the presence of kidney failure&#44; hypothyroidism&#44; cortisol deficiency and diuretic treatment should be ruled out&#46;<span class="elsevierStyleSup">1</span></p><p class="elsevierStylePara">Among the causes of SIADH&#44; those that are secondary to lung diseases have been described&#46;<span class="elsevierStyleSup">2-4</span> Possible mechanisms of induced vasopressin secretion are&#58; hypoxaemia and hypercapnia&#44; haemodynamic abnormalities&#44; alterations in the regulation and release of desmopressin caused by tumours&#44; different drugs and stress&#46;<span class="elsevierStyleSup">4</span></p><p class="elsevierStylePara">We would like to describe the case of a 68-year-old male patient who was taken to the Emergency Department because of diffuse abdominal pain and vomiting&#44; as well as alarming symptoms that included slow mental reactions and disorientation&#46; The patient had a history of chronic obstructive pulmonary disease caused by severe asthma treated chronically with oral corticosteroids&#44; non-insulin-dependent diabetes mellitus&#44; arterial hypertension and a transurethral resection of the bladder because of a neoplasia four years before&#46; The patient&#191;s usual treatment consisted of metformin&#44; simvastatin&#44; enalapril&#44; alendronic acid&#44; calcium carbonate&#44; omeprazol&#44; methylprednisone and inhaled bronchodilators&#46;</p><p class="elsevierStylePara">A blood test was carried out which revealed severe hyponatraemia 115mmol&#47;l with plasma hypoosmolality 243mOsm&#47;kg and hypouricaemia 2&#46;4mg&#47;dl&#44; with normal blood potassium and renal function&#46; There was elevated sodium loss in urine of 148mEq&#47;l&#46; The presence of hypothyroidism and adrenal failure was ruled out&#46; The patient appeared to present SIADH and so water was restricted and hypertonic intravenous saline solution was administered&#46; The patient&#191;s hyponatraemia progressively improved and his cognitive state normalised&#46; When searching for the cause of SIADH&#44; a brain MRI scan was carried out but no significant findings were made and a chest CT was performed which showed increased density of alveolar characteristics limited to basal segments of the right upper lobe that was very suggestive of pneumonia &#40;figure 1A&#41;&#46; However&#44; a chest x-ray had been carried out on admission that did not show significant changes with regard to previous tests &#40;figure 1B&#41;&#44; the respiratory auscultation was normal and there were no leukocytes or other values that indicated infection&#46; During admission the only significant symptom was an occasional fever of 37&#46;2-37&#46;4&#186; C&#46; Therefore&#44; oral levofloxacin treatment was started and six days later a new chest CT showed significant improvement in the pneumonia&#46; The urinary antigen tests for Legionella and Pneumococcus were negative&#46; Gradually&#44; the withdrawal of hypertonic saline solution was possible&#46; It was administered until discharge following 15 days in hospital with water restriction&#44; 6g per day of salt and 10mg&#47;day torsemide&#46; Plasma sodium levels remained stable at 131mmol&#47;l&#46; In the GP follow up&#44; salt and diuretics were withdrawn and a month after admission the patient had fully recovered from SIADH&#44; with plasma sodium levels 136mmol&#47;l&#46;</p><p class="elsevierStylePara">The following lung diseases have been described in the literature as potential inducers of SIADH&#58; pneumonias&#44; &#40;viral&#44; bacterial&#44; tuberculous&#44; mycotic&#41;&#44; pumonary abscesses&#44; asthma&#44; atelectasis&#44; pneumothorax and fibrocystic disease&#46;<span class="elsevierStyleSup">2-4</span> With regard to pulmonary tumours&#44; small cell carcinomas are most likely to be involved&#44; since induced SIADH is a paraneoplastic condition due to the ectopic secretion of vasopressin&#46;<span class="elsevierStyleSup">4</span> In the cases described&#44; the symptoms of pulmonary diseases stand out first and foremost&#46; In the case of our patient&#44; it is interesting that the aetiological study of SIADH led to the diagnosis of pneumonia after the chest CT was carried out&#46; Therefore we would like to highlight the importance of examining the lungs in cases of SIADH&#44; especially when dealing with immunodepressed patients who are generally treated with corticosteroids and whose symptoms of infection may be latent&#44; and thereby associated with very low clinical suspicion&#46; <br></br></p><p class="elsevierStylePara"><a href="grande&#47;43118078&#95;f1&#95;pag497&#46;jpg" class="elsevierStyleCrossRefs"><img src="43118078_f1_pag497.jpg"></img></a></p><p class="elsevierStylePara">Figure 1&#46; </p>"
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