An Autopsy Case of Amyotrophic Lateral Sclerosis Accompanied by Syndrome of Inappropriate Secretion of Antidiuretic Hormone.

Abstract

Wereport an autopsy-confirmed case of amyotrophic lateral sclerosis (ALS) accompanied by syndrome of inappropriate secretion of antidiuretic hormone (SIADH). A 67-year-old man was admitted to our hospital with muscle weakness, dysarthria and dysphagia. During hospitalization, respiratory insufficiency was ingravescent, and hyponatremia, hypo-osmolarity, elevated osmotic pressure of urine, and elevated urinary sodium excretion were noted. Based on these findings we diagnosed ALS with SIADH, and treatment with infusion of concentrated NaCl was started. However, the patient died of respiratory failure on day 50. Weassumed that severely restrictive ventilatory impairment was the cause of SIADHin this case. (Intrenal Medicine 41: 395-397, 2002)

Syndrome of Inappropriate Antidiuretic Hormone Secretion Associated with Amyotrophic Lateral Sclerosis in a Patient Developing Carbon Dioxide Narcosis

“…The finding of SIADH accompanied by ALS is very rare ( 5 ). To the best of our knowledge, only seven cases of SIADH accompanied by ALS, including our case, have been reported ( 5 , 9 - 12 ).…”

“…The finding of SIADH accompanied by ALS is very rare ( 5 ). To the best of our knowledge, only seven cases of SIADH accompanied by ALS, including our case, have been reported ( 5 , 9 - 12 ). Although ALS is clinically progressive and serious, it is both a rare and unfamiliar disease to primary care physicians and endocrinologists, who are likely to be primarily in charge of patients with hyponatremia in the clinical setting.…”

“…Moreover, four out of the seven reported cases of SIADH accompanied by ALS presented with hyponatremia almost concomitantly with the diagnosis of ALS. The remaining three cases were diagnosed with ALS prior to the occurrence of hyponatremia ( 5 , 9 - 12 ). This suggests that we should recognize ALS as a possible cause of SIADH.…”

“…SIADH is caused by various conditions, such as central nervous system disorders, malignant neoplasms, nonmalignant pulmonary diseases, invasive procedures, and adverse drug reactions. Amyotrophic lateral sclerosis (ALS) or motor neuron disease, which is a rare but clinically progressive and serious disease, is not a well-known cause of SIADH ( 5 ). Moreover, the underlying mechanism remains unclear ( 5 ).…”

“…Amyotrophic lateral sclerosis (ALS) or motor neuron disease, which is a rare but clinically progressive and serious disease, is not a well-known cause of SIADH ( 5 ). Moreover, the underlying mechanism remains unclear ( 5 ). We herein report a case of ALS-associated SIADH.…”