The syndrome of inappropriate secretion of antidiuretic hormone associated with cleft palate: report of a case and review of the literature.

A case of the inappropriate secretion of antidiuretic hormone syndrome (SIADH) associated with uneventful repair of a cleft palate in a child with Pierre Robin syndrome is reported. Excess secretion of ADH is seen with pulmonary disease, intracranial infections, and trauma and as a side effect of numerous drugs. Symptoms may be vague but ultimately progress to seizure or coma. Diagnosis is made by confirming hyponatremia and serum hyposmolality in the presence of less than maximally dilute urine with relative sodium wasting. Treatment usually consists of reversing the underlying disorder, fluid restriction, and occasionally hypertonic saline or drug administration. Because of its association with neurological disorders, SIADH should be considered in any patient with an unexplained change in neurological symptoms.