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肌萎缩侧索硬化相关呼吸衰竭及与抗利尿激素分泌不当综合征的关联。

Amyotrophic Lateral Sclerosis-Related Respiratory Failure and Association With Inappropriate Secretion Syndrome of the Antidiuretic Hormone.

作者信息

Ceriz Tiago, Diegues Andreia, Alves Sérgio R, Simões Pedro, Blanco Miriam P

机构信息

Internal Medicine Department, Unidade Local de Saúde do Nordeste, Bragança, PRT.

Internal Medicine Department, Unidade Local de Saúde de Bragança, Bragança, PRT.

出版信息

Cureus. 2023 Feb 10;15(2):e34851. doi: 10.7759/cureus.34851. eCollection 2023 Feb.

Abstract

There is an unclear association between the syndrome of inappropriate antidiuretic hormone secretion (SIADH) and amyotrophic lateral sclerosis (ALS), with few reports in the literature. We report the case of an 80-year-old man admitted to our emergency room with asthenia, dysphonia, dysphagia, weight loss, and euvolemic hyponatremia, indicating a SIADH. Posteriorly, the patient also developed respiratory failure, which, in association with the previous clinical presentation, led to the diagnosis of ALS. During her permanence at the hospital, the hyponatremia improved with noninvasive positive-pressure ventilation, and the association between these two identities was made. This case also shows that patients with ALS commonly suffer from chronic respiratory failure and still have a reserved prognosis.

摘要

抗利尿激素分泌不当综合征(SIADH)与肌萎缩侧索硬化症(ALS)之间的关联尚不明确,文献报道较少。我们报告一例80岁男性患者,因乏力、声音嘶哑、吞咽困难、体重减轻和血容量正常的低钠血症入住我院急诊室,提示为SIADH。随后,患者出现呼吸衰竭,结合先前的临床表现,最终诊断为ALS。在住院期间,通过无创正压通气,低钠血症得到改善,从而明确了这两种病症之间的关联。该病例还表明,ALS患者常伴有慢性呼吸衰竭,且预后尚可。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fbd1/10009550/fe3aa30a8ceb/cureus-0015-00000034851-i01.jpg

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