Gen Shiko, Ogawa Akio, Kanai Koji, Nobe Kanako, Ikeda Naofumi, Mochizuki Atsuko, Tokushige Kazuo
Department of Nephrology, Saitama Sekishinkai Hospital, Saitama, Japan.
Department of Neurology, Saitama Sekishinkai Hospital, Saitama, Japan.
Case Rep Med. 2018 Aug 6;2018:9496149. doi: 10.1155/2018/9496149. eCollection 2018.
We treated a patient with neurosarcoidosis, which caused the syndrome of inappropriate secretion of antidiuretic hormone (SIADH), in whom diagnosis was performed using neuroendoscopy. The patient was a 56-year-old female who was hospitalized for hyponatremia and diagnosed with SIADH based on a detailed examination. During the course, she developed impaired consciousness due to acute hydrocephalus, which improved after ventricular drainage. Head magnetic resonance imaging (MRI) confirmed nodular lesions at the floor of the third ventricle and the cerebral aqueduct. Neuroendoscopic biopsy led to the diagnosis of neurosarcoidosis. Her hyponatremia improved after steroid therapy. Neurosarcoidosis can cause SIADH, and complication of hydrocephalus may lead to a poor prognosis. Neuroendoscopy appears to be effective for the diagnosis of neurosarcoidosis with hydrocephalus and helps in deciding the treatment modality.
我们治疗了一名患有神经结节病的患者,该疾病导致抗利尿激素分泌不当综合征(SIADH),我们通过神经内镜检查对其进行了诊断。患者为一名56岁女性,因低钠血症住院,经详细检查后被诊断为SIADH。在此过程中,她因急性脑积水出现意识障碍,脑室引流后病情好转。头部磁共振成像(MRI)证实第三脑室底部和中脑导水管有结节性病变。神经内镜活检确诊为神经结节病。类固醇治疗后她的低钠血症有所改善。神经结节病可导致SIADH,脑积水并发症可能导致预后不良。神经内镜检查似乎对伴有脑积水的神经结节病诊断有效,并有助于确定治疗方式。