Carrillo ER, Wasung LM, Balderas JJ, Fuentes VA, Sosa GJO, Castro ME

Language: Spanish
References: 11
Page: 390-392
PDF size: 212.78 Kb.

ABSTRACT

Introduction. The syndrome of inappropriate secretion of antidiuretic hormone (SIADH) is a cause of hyponatremia and diverse etiology, with the Guillain Barré Syndrome (GBS), an uncommon association of SIADH.
Cinical Case. Women 73 years. Income quadriparesis 5 days of evolution. The paraclinical with hyponatremia of 115 mmol/L, serum osmolality 254 mOsm/kg, urine specific gravity 1.022, urinary osmolarity of 880 mOsm/kg, urinary sodium of 147 mmol/L. Thyroid hormone profile was carried out with total T3 0.82 ng/mL (0.87-1.78 ng/mL), free T3 2.44 pg/mL (2.50 - 3.90 ng/mL), total T4 12.16 mg/dL (6.09-12.23 mg/dL ), cortisol levels of 35.6 g/dL (8.7-22.4 g/dL) and cerebrospinal fluid cytochemical with dissociation albuminocytologic and nerve conduction studies consistent with acute demyelinating polyneuropathy.
Conclusions. SIADH secondary to GBS is a rare association should be considered as a cause of hyponatremia in patients with data compatible with this entity. The aim of this paper is to present the scientific community for a patient with SIADH and SGB.

REFERENCES

1. Saito T. Inappropriate secretion of antidiuretic hormone in a patient with a chronic inflammatory demyelinating polyneuropathy. Intern Med 2005;44 (7):685-686.

2. Zimmerman EA, Nilaver G, Hoy-Yu A, Silverman AJ. Vasopressinergic and oxytocinergic pathways in the central nervous system. Fed Proc 1984;43:91-96.

3. Rose BD, Post TW. Clinical Physiology of acid-base and electrolyte disorders. 5a ed. New York: McGrawHill, 2001;707-711.

4. Hughes R, Newson Davis JM, Perkins GD, Pierce JM. Controlled trial of prednisolone in acute polyneuropathy. Lancet 1978;2:750-753.

5. Riggs J. Neurological manifestations of electrolyte disturbances. Neurologic Clincs 2002;20:227-239.

6. Verbalis J, Goldsmith S, Greenberg A, Schrier R, Sterns R. Hyponatraemia treatment guidelines 2007: expert panel recommendations. Am J Med 2007;120:1-21.

7. Ellison DH, Berl T. Clinical practice. The syndrome of inappropriate antidiuresis. N Eng J Med 2007; 356: 2064-2072.

8. Posner JB, Ertel NH, Kossman RJ, Scheinberg LC. Hyponatraemia in acute polyneuropathy. Arch Neurol 1967;17:530-541.

9. Hoffmann O, Reuter U, Scielke E, Weber JR. SIADH as the first symptom of Guillain Barré syndrome. Neurology 1999;53:1365.

10. Cooke CR, Latif KA, Huch KM, Wall BM. Inappropriate Antidiuresis and hyponatremia with suppressible vasopressin in Guillain-Barré Syndrome. Am J Nephrol 1998;18:71-76.

11. Hughes RCA, Cornblath DR. Guillain-Barré syndrome. Lancet 2005;366: 1653-1666.