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Syndrome of Inappropriate Antidiuretic Hormone Secretion, Pediatric

Todd D. Nebesio, MD, FAAP Reviewed 10/2018
 


BASICS

DESCRIPTION

Inappropriate secretion of antidiuretic hormone (ADH) or ADH-like peptide in the presence of low serum sodium, low serum osmolality, and high urine osmolality and in the absence of r...

DIAGNOSIS

HISTORY

  • Unusual water intake (suspicious for psychogenic polydipsia)

  • Review of intake and output for inpatients

  • Decreased urine output

  • Anorexia, lethargy

  • Weight gain or weight loss

  • Renal disease

  • Vo...

TREATMENT

GENERAL MEASURES

  • The most important aspects of therapy for SIADH are diagnosis and treatment of the underlying cause.

  • If hyponatremic and sodium >120 mEq/L and no neurologic signs, first st...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • When to expect improvement: After about 48 to 72 hours of fluid restriction, the serum sodium level will gradually start to increase.

  • Signs to wa...

ADDITIONAL READING

  • Cuesta M, Thompson CJ. The syndrome of inappropriate antidiuresis (SIAD). Best Pract Res Clin Endocrinol Metab.  2016;30(2):175–187. [View Abstract on OvidInsights]

  • Ellison DH, ...

CODES

ICD9

253.6 Other disorders of neurohypophysis 

ICD10

E22.2 Syndrome of inappropriate secretion of antidiuretic hormone 

SNOMED

55004003 Syndrome of inappropriate vasopressin secretion (disorder) 

FAQ

  • Q: Is diuretic use beneficial in treating SIADH?

  • A: No. Although diuretics may relieve the effects of volume overload, they can also worsen hyponatremia. Overall, diuretics usually cause more detri...

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