East Carolina University, Greenville, NC, USA.
Ann Pharmacother. 2013 Oct;47(10):1359-63. doi: 10.1177/1060028013502457.
To report a case of ciprofloxacin-induced syndrome of inappropriate antidiuretic hormone (SIADH).
A 68-year-old Caucasian woman presented on 2 separate occasions with generalized weakness. Both times, she was started on ciprofloxacin for a urinary tract infection. Prior to the first episode, she had also been on Augmentin for several days. On both occasions, her ciprofloxacin was discontinued on admission, and her sodium levels rose. On the first occasion, she was given 5% dextrose in water to slow the rate of rise, yet she still corrected faster than the recommended rate. After the second admission, she was briefly given hypertonic saline but remained off intravenous fluids, and her sodium again rose faster than the recommended rate.
An objective causality assessment using the Naranjo scale was done. A score of 8 revealed a probable causality between ciprofloxacin and SIADH. The likely mechanism of this reaction is ciprofloxacin crossing the blood-brain barrier and stimulating the γ-aminobutyric acid and N-methyl-D-aspartate receptors, which leads to the synthesis and release of antidiuretic hormone.
Fluoroquinolones have the potential to cause SIADH. In this case, ciprofloxacin probably caused SIADH.
报告 1 例环丙沙星引起的抗利尿激素不适当分泌综合征（SIADH）。
一位 68 岁的白人女性因全身无力就诊 2 次。两次均因尿路感染开始使用环丙沙星。在第一次发作前，她还服用了几天阿莫西林克拉维酸钾。两次入院时均停用环丙沙星，且钠水平升高。第一次入院时，给予 5%葡萄糖水以减缓升高速度，但仍比推荐速度快纠正。第二次入院后，曾短暂给予高渗盐水，但仍未给予静脉补液，钠再次比推荐速度快升高。
使用 Naranjo 量表进行了客观的因果关系评估。8 分提示环丙沙星与 SIADH 之间存在可能的因果关系。这种反应的可能机制是环丙沙星穿过血脑屏障并刺激γ-氨基丁酸和 N-甲基-D-天冬氨酸受体，导致抗利尿激素的合成和释放。
氟喹诺酮类药物有可能引起 SIADH。在本例中，环丙沙星可能导致了 SIADH。
