Syndrome of inappropriate antidiuresis associated with multiple sclerosis
Introduction
Many disorders of the nervous system have been reported to be associated with the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) [1]. However, the syndrome has been infrequently described in patients with multiple sclerosis. We present the case report of a woman who suffered from multiple sclerosis and developed hyponatremia due to SIADH.
Section snippets
Case report
A 58-year-old woman was admitted to our hospital because of fever, flank pain and irritative voiding symptoms. She had a 17-year history of chronic primary progressive multiple sclerosis. Methotrexate (7.5 mg once a week) was started 3 weeks before admission due to the disease relapse. She has been receiving levothyroxine (100 μg/day) since hypothyroidism was diagnosed 1 year ago. She has been suffering from non-ulcer dyspepsia for which she has been taking cisapride and omeprazole.
On
Discussion
Our patient fulfilled the criteria for the diagnosis of the syndrome of inappropriate antidiuresis, since she developed hyponatremia with hypoosmolality, increased Uosm, and inappropriate natriuresis in association with normal renal, adrenal and thyroid function in the absence of significant changes of acid–base homeostasis [1]. This diagnosis was reinforced by the absence of any clinical or laboratory indications of hypovolemia (i.e. postural hypotension, increased urea/creatinine ratio,
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