What should be considered in the medical history of suspected syndrome of inappropriate antidiuretic hormone secretion (SIADH)?

Updated: Aug 16, 2019
  • Author: Christie P Thomas, MBBS, FRCP, FASN, FAHA; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

Depending on the magnitude and rate of development, hyponatremia may or may not cause symptoms. The history should take into account the following considerations:

  • In general, slowly progressive hyponatremia is associated with fewer symptoms than is a rapid drop of serum sodium to the same value

  • Signs and symptoms of acute hyponatremia do not precisely correlate with the severity or the acuity of the hyponatremia

  • Patients may have symptoms that suggest increased secretion of AVP, such as chronic pain, symptoms from central nervous system or pulmonary tumors or head injury, or drug use

  • Sources of excessive fluid intake should be evaluated

  • The chronicity of the condition should be considered


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