SIADH as presenting feature in a male with coexisting sarcoidosis and systemic lupus

Abstract

We

Hypothalamic-Pituitary Axis Dysfunction, Central Diabetes Insipidus, and Syndrome of Inappropriate Antidiuretic Hormone Secretion as the First Clinical Presentation of Neurosarcoidosis: Why Early Diagnosis and Treatment is Important?

“…In all previously reported studies, a history of additional symptoms like erythema nodosum, uveitis, cough, and dyspnea, led to a more detailed investigation to determine the primary cause of SIADH [42,43]. MRI findings of the central nervous system included thickening of the floor of the third ventricle and meningeal enhancement [15,42]. Nevertheless, in one reported case, a patient diagnosed with SIADH and subsequently with hydrocephalus had no other symptoms associated with sarcoidosis.…”

“…The etiology of SIADH can include the ectopic release of ADH, adverse effects of different drugs, or various central nervous system disorders like infections, trauma, and neoplasia [39,40]. Interestingly, neurosarcoidosis, despite more frequently inducing deficiency of ADH, can also be a reason behind the excess production of ADH [15,[41][42][43]. Up to date, we were able to find only four studies in the literature describing sarcoidosis as a definitive cause of SIADH ( Table 2).…”

“…Inappropriate ADH secretion in a patient with systemic sarcoidosis [41] 1992 No SIADH as presenting feature in a male with coexisting sarcoidosis and systemic lupus [42] 2013 No A rare presentation of sarcoidosis with SIADH: a case report [43] 2016 No A case of neurosarcoidosis-induced syndrome of inappropriate secretion of ADH diagnosed with neuroendoscopy [15] 2018 No…”

“…For a definitive diagnosis of SIADH, renal failure, adrenal insufficiency, severe hypothyroidism, and nonosmotic stimuli of ADH secretion like pain, nausea, and stress must be excluded [45]. In all previously reported studies, a history of additional symptoms like erythema nodosum, uveitis, cough, and dyspnea, led to a more detailed investigation to determine the primary cause of SIADH [42,43]. MRI findings of the central nervous system included thickening of the floor of the third ventricle and meningeal enhancement [15,42].…”

“…In the case of neurosarcoidosis-induced SIADH, the mainstay of treatment is glucocorticoids. In all reported cases, serum sodium levels normalized, and clinical symptoms improved after corticosteroid therapy [15,[41][42][43]. It is essential to highlight that in one case, hyponatremia failed to improve despite recurrent 3% normal saline infusions, and the correction was confirmed after corticosteroid administration [43].…”