Syndrome Of Inappropriate Antidiuretic Hormone Secretion Associated With Amyotrophic Lateral Sclerosis In A Patient Developing Carbon Dioxide Narcosis
INTERNAL MEDICINE(2017)
Abstract
We report a rare case of syndrome of inappropriate antidiuretic hormone secretion ( SIADH) associated with amyotrophic lateral sclerosis (ALS). A 69-year-old man was admitted to our hospital with sustained hyponatremia. Hyposmolality with elevated urinary osmolality and sodium excretion was observed, which indicated SIADH. The treatment for SIADH was challenging; the patient developed carbon dioxide narcosis, which led to the diagnosis of ALS. After the initiation of noninvasive positive-pressure ventilation, the patient's serum sodium concentration normalized and became stable. Thus, ALS should be recognized as a possible cause of SIADH in the clinical setting.
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Key words
hyponatremia, SIADH, ALS, NPPV, CO2 narcosis, respiratory failure
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