Division of Pediatric Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
Division of Pediatric Endocrinology, Department of Pediatrics, All India Institute of Medical Sciences, Room No. 3058, Teaching Block, New Delhi, 110029, India.
Indian J Pediatr. 2024 Feb;91(2):188-190. doi: 10.1007/s12098-023-04472-5. Epub 2023 Feb 9.
Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is one of the common causes of euvolemic hyponatremia (serum Na < 135 mEq/L) in hospitalized children. It is characterized by increased serum ADH, leading to water retention via its action on V2 receptors in the distal renal tubules. Various conditions such as pain, the postoperative state, drugs, central nervous system infections, tumors, malformations, and pneumonia can predispose a person to SIADH. The conventional treatment of SIADH includes fluid restriction and salt supplementation. Occasionally, this may fail to control hyponatremia, mandating pharmacological therapy. V2-receptor antagonists are an FDA-approved therapy for adults with euvolemic and hypervolemic hyponatremia. However, there is limited experience with their use in the pediatric population. Here, the authors present a girl with corpus callosum agenesis with severe symptomatic hyponatremia due to SIADH who was successfully managed with the V2-receptor antagonist tolvaptan.
抗利尿激素分泌不当综合征（SIADH）是住院儿童等容量性低钠血症（血清 Na < 135mEq/L）的常见原因之一。其特征是血清 ADH 增加，通过其在远曲小管 V2 受体上的作用导致水潴留。疼痛、术后状态、药物、中枢神经系统感染、肿瘤、畸形和肺炎等各种情况可使患者易发生 SIADH。SIADH 的常规治疗包括限制液体摄入和补充盐分。偶尔，这可能无法控制低钠血症，需要药物治疗。V2 受体拮抗剂是 FDA 批准的用于治疗等容量性和高容量性低钠血症的成人的药物。然而，在儿科人群中使用这种药物的经验有限。在这里，作者介绍了一例因 SIADH 导致严重症状性低钠血症的胼胝体发育不全的女孩，她成功地接受了 V2 受体拮抗剂托伐普坦治疗。
