Department of Cardiology, Nephrology, and Endocrinology (A.-S.S., A.-L.T., U.P.-B., P.E.), Nordsjællands Hospital, DK-3400 Hillerød, Denmark; Faculty of Health Sciences (A.-S.S.), University of Southern Denmark, DK-5000 Odense, Denmark; and Faculty of Health Sciences (U.P.-B., P.E.), University of Copenhagen, DK-2200 Copenhagen, Denmark.
J Clin Endocrinol Metab. 2014 Oct;99(10):3527-30. doi: 10.1210/jc.2014-1572. Epub 2014 Jun 27.
Recent studies show an association between hyponatremia and osteoporosis. We have previously reported a case of severe male osteoporosis due to chronic syndrome of inappropriate secretion of antidiuretic hormone (SIADH). Here, we provide a follow-up on this case after cure of the condition that further supports the causal relationship.
A 38-year-old man had been diagnosed with severe osteoporosis most likely due to chronic SIADH. The SIADH was believed to be idiopathic. A magnetic resonance imaging scan, however, revealed a tumor in the sinus, and biopsies showed an esthesioneuroblastoma, immunohistochemically positive for antidiuretic hormone (ADH). After the tumor was removed, ADH and sodium levels normalized. A dual-energy x-ray absorptiometry scan performed 7 months after the patient's last surgery showed a significant spontaneous improvement in bone mineral density in the lumbar vertebrae.
This case provides evidence for a causal relationship between SIADH and chronic hyponatremia and impaired bone metabolism that can lead to severe secondary osteoporosis. The effect on bone metabolism is at least partially reversible.
最近的研究表明低钠血症与骨质疏松症之间存在关联。我们之前曾报道过一例因抗利尿激素分泌不当综合征（SIADH）导致的严重男性骨质疏松症病例。在此，我们提供了该病例在病情治愈后的随访结果，进一步支持了因果关系。
一名 38 岁男性被诊断为严重的骨质疏松症，极有可能是由于慢性 SIADH 所致。SIADH 被认为是特发性的。然而，磁共振成像扫描显示窦内有肿瘤，活检显示为嗅神经母细胞瘤，免疫组化显示抗利尿激素（ADH）阳性。肿瘤切除后，ADH 和钠水平恢复正常。患者最后一次手术后 7 个月进行的双能 X 射线吸收仪扫描显示，腰椎骨矿物质密度有显著的自发性改善。
本病例提供了证据表明，SIADH 和慢性低钠血症以及受损的骨代谢之间存在因果关系，可导致严重的继发性骨质疏松症。对骨代谢的影响至少部分是可逆的。
