Inappropriate secretion of antidiuretic hormone
Keywords:
syndrome of inappropriate secretion of antidiuretic hormone, hyponatremia, schizophrenia, neurolepticsAbstract
We report a case of schizophrenia associated to syndrome of inappropriate secretion of anti diuretic hormone. Clinicai and laboratory signs are discussed, emphasing etiologic factors asso ciated with this syndrome.
Recent studies have shown that hyponatremia in chronic psychiatric patients can be explained by two main mecanisms: potomania and/or the syndrome of inappropriate secretion of ADH.
Hyponatremic encephalopathy was first described by Rowntree in 1923 and characterized by: headaches, blurred vision, weakness, cramps, salivation, vomiting, diarrhoea, seizures and coma.
We describe a schizophrenic patient with multiple potential causes of hyponatremia such as primary polydipsia and the syndrome of inap propriate secretion of antidiuretic hormone in duced by psychotropic drugs - neuroleptics - and smoking. His situation improved with isotonic saline infusion and water restriction although he remained on small doses of neuroleptics.
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