Resistant syndrome of inappropriate antidiuretic hormone (SIADH) secondary to atonic bladder in an older woman

Abstract

Syndrome of inappropriate antidiuretic hormone (SIADH) is the most common cause of hyponatraemia. There are many causes of SIADH, but investigation tends to focus around the most common causes—particularly diseases of the brain and lung, malignancy and medication-induced SIADH [Ellison and Berl (2007, The Syndrome of Inappropriate Antidiuresis. N Engl J Med., 356, 2064–72]. We describe a case of SIADH secondary to atonic bladder in an 83-year old woman, which was discovered on MRI of the abdomen, performed for further characterisation of a known pancreatic lesion. Insertion of a urinary catheter alleviated retention and resulted in prompt resolution of hyponatraemia. This is an under-recognised cause of this common condition, with important implications for investigation and management.

Hyponatraemia caused by transient syndrome of inappropriate antidiuresis to urinary retention

“…All patients received an IDC and were treated with fluid restriction of 800 to 1000 mL per day, resulting in normalisation of sodium in all patients within 3 days. In four patients, the sodium level corrected slowly within 2 to 10 days 2,6–8 . In five patients, a rapid autocorrection was described, where sodium normalised in 7 to 15 h 4,5,7,9 .…”

“…In four patients, the sodium level corrected slowly within 2 to 10 days. 2,[6][7][8] In five patients, a rapid autocorrection was described, where sodium normalised in 7 to 15 h. 4,5,7,9 No cases were described in which patients were administered desmopressin, as in our cases. To allow a controlled and gradual rise of serum sodium of maximum of 10 mmol/24 h. 10 We successfully combined desmopressin and fluid restriction in two of our patients, preventing osmotic demyelination (Table 2).…”

“…Although it is not a well‐known cause of hyponatraemia, the coexistence of hyponatraemia and urinary retention has been previously described. We performed a search of the literature and found one case series and seven case reports 2–9 describing a total of 14 cases. There was no difference in sex of the patients (seven men and seven women).…”

Postoperative urinary retention induced hyponatremic seizure following total knee arthroplasty with an enhanced recovery after surgery protocol: a case report and literature review

“…The literature review methods, including search strategy, selection criteria, study selection, and data extraction, were provided in Additional le 1. A total of 13 studies consisting of 21 patients were reviewed (Table 1) [4][5][6][7][8][9][10][11][12][13][14][15][16].…”