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Antidiuretic hormone (ADH) is released from the posterior pituitary for a number of physiologic reasons. The majority of people with hyponatremia, other than those with excessive water intake or renal salt wasting, will have elevated ADH as the cause of their hyponatremia. However, not every person with hyponatremia and elevated ADH has SIADH.
This syndrome does not appear to be exclusively linked to childbirth, as Sheehan's syndrome has been reported in pregnant patients that experienced massive hemorrhage from non-obstetrical causes. [9] The pituitary gland grows and has a higher metabolic demand during pregnancy because the pituitary needs to rev up the production of certain ...
The treatment of hyponatremia depends on the underlying cause. [12] How quickly treatment is required depends on a person's symptoms. [12] Fluids are typically the cornerstone of initial management. [12] In those with severe disease an increase in sodium of about 5 mmol/L over one to four hours is recommended. [12]
The cornerstone of therapy for SIADH is reduction of water intake. If hyponatremia persists, then demeclocycline (an antibiotic with the side effect of inhibiting ADH) can be used. SIADH can also be treated with specific antagonists of the ADH receptors, such as conivaptan or tolvaptan. [citation needed] Another cause is psychogenic polydipsia. [3]
The most obvious cause is a kidney or systemic disorder, including amyloidosis, [2] polycystic kidney disease, [3] electrolyte imbalance, [4] [5] or some other kidney defect. [2] The major causes of acquired nephrogenic diabetes insipidus that produce clinical symptoms (e.g., polyuria) in the adult are lithium toxicity and high blood calcium.
This means that psychogenic polydipsia may lead to test results (e.g. in a water restriction test) consistent with diabetes insipidus or SIADH, leading to misdiagnosis. [14] Dry mouth is often a side effect of medications used in the treatment of some mental disorders, rather than being caused by the underlying condition. [15]
SIADH causes HYPOnatremia not HYPERnatremia, since the nephrons don't allow the loss of as much water as they should. They still lose the sodium, so since the sodium level drops but the water level doesn't drop as fast, HYPOnatremia delvelops. As far as I could see, the article does call, it HYPOnatremia, which is correct.
Tolvaptan, sold under the brand name Samsca among others, is an aquaretic drug that functions as a selective, competitive vasopressin receptor 2 (V 2) antagonist used to treat hyponatremia (low blood sodium levels) associated with congestive heart failure, cirrhosis, and the syndrome of inappropriate antidiuretic hormone (SIADH).