A 36-year-old man is brought to ER by his wife because of lethargy, weakness and confusion. Serum sodium and serum osmolality are markedly decreased. Urine osmolality is increased. These findings are most likely related to which of the following?
- Given clinical features suggests the diagnosis of syndrome of inappropriate ADH (SIADH) secretion. SIADH - Associated with ADH excess, which causes resorption of excessive amount of free water, resulting in hyponatremia. - Causes of SIADH Secretion of ectopic ADH by malignant neoplasms (small-cell carcinomas of lung, intracranial neoplasms); Non-neoplastic diseases of lung Local injury to hypothalamus / neurohypophysis. - C/F- Hyponatremia, cerebral edema & neurologic dysfunction. - Cardinal features- Marked | in both serum sodium & osmolality | Urine osmolality. - Although total body water is increased, blood volume remains normal & peripheral edema does not develop.
Bronchogenic carcinoma
Thymoma
Small cell carcinoma of lung
Renal cell carcinoma
Miscellaneous