Chronic Hyponatremia Due to the Syndrome of Inappropriate Antidiuresis (SIAD) in an Adult Woman with Corpus Callosum Agenesis (CCA)

Abstract

Patient: Female, 41Final Diagnosis: Syndrome of inappropriate antidiuresisSymptoms: Gait disturbanceMedication: —Clinical Procedure: Teatment of chronic hyponatremiaSpecialty: NephrologyObjective:Rare co-existance of disease or pathologyBackground:Corpus callosum agenesis (CCA) is one of the most common congenital brain abnormalities, and is associated with neurodevelopmental and neuropsychiatric disorders. In CCA, defects in osmoregulation have been reported. This report presents a rare case of chronic hyponatremia associated with the syndrome of inappropriate antidiuresis (SIAD) in a woman with CCA.Case Report:A 41-year-old woman presented to the renal unit with symptomatic hyponatremia. In her past medical history, she had a four-year history of systemic arterial hypertension and Sjögren’s syndrome, and a three-year history of systemic lupus erythematosus (SLE), which was treated with cyclophosphamide. She had CCA but with irregular neurological follow-up. During the previous eight years, her plasma sodium levels ranged from between 118–134 mEq/L. On this hospital admission, she had plasma hypo-osmolality, measured in milli-osmoles per kilogram of H2O (mOsm/kg H2O), of 251 mOsm/Kg H2O, and a urinary hyper-osmolality of 545 mOsm/Kg H2O, and increased level of plasma antidiuretic hormone (ADH) (1.8 pg/ml). Bone densitometry was consistent with osteoporosis. The patient remained asymptomatic during her hospital stay. Chronic hyponatremia associated with the SIAD was diagnosed. Water restriction and increased protein intake resulted in a partial improvement in the serum sodium level (128–134 mEq/L). The patient was discharged from the hospital with outpatient follow-up.Conclusions:A rare case of chronic hyponatremia due to the SIAD associated with CCA is reported that demonstrates the importance of correct diagnosis, management, and clinical follow-up of the SIAD, including bone densitometry.

Corpus Callosum Agenesis: An Insight into the Etiology and Spectrum of Symptoms

“…However, normocephaly is also found in the ACC population [ 9 ]. Fetuses with an isolated case of agenesis are at a higher risk of chromosomal anomalies [ 51 ], including trisomies, deletions, missense, nonsense and truncating mutations and frameshifts [ 56 , 57 ].…”

“…It was assumed that in this rare case of the concomitance of ACC and SIAD, the above diseases were the aggravating factors, which caused chronic hyponatremia. It can result in neurological symptoms such as cognitive deficit, impairment of mobility and attention deficit [ 57 ].…”

Fraction of the T-Tubular Membrane as an Important Parameter in Cardiac Cellular Electrophysiology: A New Way of Estimation

“…Thus, paired comparison of the differences may be done which is the preferable way of evaluation whenever it is possible. Since the estimated f t did not differ during the first and second sucrose application in the same cells ( Figure 5 ), the method may be used even for analysis of short-term changes in structure and function of the t-tubular system, induced by e.g., a transient hypoosmotic state ( Moench et al, 2013 ) which may be relevant for the clinical practice (e.g., Kanda et al, 2004 ; Silveira et al, 2018 ). Both the paired statistical testing and analysis of short-term changes of the t-tubules are impossible when the usually used detubulation method is applied.…”

Severe symptomatic hyponatremia due to cerebral salt wasting syndrome in a patient with traumatic head injury and Dandy-Walker malformation of the brain

“…To our knowledge, cases of Dandy-Walker malformation in association with hyponatremia have not previously been reported. However, case reports of other congenital CNS anomalies, such as agenesis of the corpus callosum [ 17 , 18 ] and Rathke’s cleft cyst [ 19 , 20 ] exist that have been associated with chronic hyponatremia attributed to SIADH but not CSW.…”