Syndrome of inappropriate antidiuretic hormone classification: Difference between revisions

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* Accounts for about 60-70% of [[SIADH]]
* Accounts for about 60-70% of [[SIADH]]
*Excessive secretion of [[AVP]] is noted  
*Excessive secretion of [[arginine vasopressin]] ([[AVP]]) is noted  
*Associated with [[lung cancer]] and [[Nasopharyngeal Carcinoma|nasopharyngeal tumors]]
*Associated with [[lung cancer]] and [[Nasopharyngeal Carcinoma|nasopharyngeal tumors]]
* Patients are more susceptible to development of severe [[hyponatremia]]
* Patients are more susceptible to development of severe [[hyponatremia]]
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* Failure to suppress [[AVP]] secretion at [[Plasma osmolality|plasma osmolalities]]  below the [[osmotic]] threshold
* Failure to suppress [[AVP]] secretion at [[Plasma osmolality|plasma osmolalities]]  below the [[osmotic]] threshold
* Occurs due to dysfunction of [[inhibitory neurons]] in the [[hypothalamus]], leading to persistent low-grade basal [[AVP]] secretion
* Occurs due to dysfunction of inhibitory [[neurons]] in the [[hypothalamus]], leading to persistent low-grade basal [[AVP]] secretion


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* Low or undetectable [[AVP]] levels and circulating [[AVP]] response is not defective   
* Low or undetectable [[AVP]] levels and circulating [[AVP]] response is not defective   
*Nephrogenic [[SIADH]] (NSIAD) may be attributed to this condition  
*Nephrogenic SIADH (NSIAD) may be attributed to this condition  
*Associated with gain-of-function [[mutations]] in the [[V2 receptor]] leading to a clinical picture of [[SIADH]], with undetectable [[AVP]] levels  
*Associated with gain-of-function [[mutations]] in the vasopressin-2 ([[V2 receptor|V2]]) [[V2 receptor|receptor]] leading to a clinical picture of [[SIADH]], with undetectable [[AVP]] levels  
*The condition is inherited in an [[X-linked]] manner, although [[heterozygous]] females may have inappropriate antidiuresis of varying degrees.  
*The condition is inherited in an [[X-linked]] manner, although [[heterozygous]] [[females]] may have inappropriate anti-[[diuresis]] of varying degrees.  


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Revision as of 15:33, 15 November 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vindhya BellamKonda, M.B.B.S [2]

Overview

SIADH may be classified into several sub-types based on the pattern of arginine vasopressin (AVP) secretion in response to a range of plasma osmolalities into type A, type B, type C, and type D.

Classification

SIADH may be classified into several sub-types based on the pattern of arginine vasopressin (AVP) secretion across a range of plasma osmolalities:[1][2][3]

Classification Features
Type A
Type B
Type C
Type D
  • Low or undetectable AVP levels and circulating AVP response is not defective
  • Nephrogenic SIADH (NSIAD) may be attributed to this condition
  • Associated with gain-of-function mutations in the vasopressin-2 (V2) receptor leading to a clinical picture of SIADH, with undetectable AVP levels
  • The condition is inherited in an X-linked manner, although heterozygous females may have inappropriate anti-diuresis of varying degrees.

References

  1. Hannon MJ, Thompson CJ (2010). "The syndrome of inappropriate antidiuretic hormone: prevalence, causes and consequences". Eur. J. Endocrinol. 162 Suppl 1: S5–12. doi:10.1530/EJE-09-1063. PMID 20164214.
  2. Yamauchi T, Makinodan M, Nagashima T, Kiuchi K, Noriyama Y, Kishimoto T (2009). "Type d syndrome of inappropriate antidiuretic hormone secretion in a schizophrenia patient with polydipsia". J Brain Dis. 1: 25–7. PMC 3676320. PMID 23818806.
  3. Gross P (2012). "Clinical management of SIADH". Ther Adv Endocrinol Metab. 3 (2): 61–73. doi:10.1177/2042018812437561. PMC 3474650. PMID 23148195.

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