Shimada T, Higashi K, Kimura K, Shido T, Tomita K
Department of Internal Medicine, Kumamoto National Hospital, Japan.
Endocr J. 1995 Apr;42(2):163-9. doi: 10.1507/endocrj.42.163.
We present a rare case of a 66-year-old woman with the syndrome of inappropriate antidiuresis (SIAD) accompanied by an empty sella whose symptoms were seen twice in the eight years after the administration of non-steroidal anti-inflammatory drugs (NSAID) or prochlorperazine. No diuresis or suppression of the plasma level of vasopressin (AVP) was observed after water loading upon cessation of the causative agents. Suppression of the renin-aldosterone system and a low plasma level of atrial natriuretic peptide (ANP) were observed during natriuresis. The plasma levels of AVP were increased after water loadings. Restriction of water intake ameliorated the symptoms and reduced hyponatremia. These findings suggest that NSAID or prochlorperazine caused overt SIAD twice in eight years. The water loading test itself stimulated the release of AVP and a suppression of the renin-aldosterone system played a more important role in natriuresis than ANP in this case.
我们报告了一例罕见病例，一名66岁女性患有抗利尿激素分泌失调综合征（SIAD）并伴有空蝶鞍，其症状在使用非甾体抗炎药（NSAID）或氯丙嗪后的八年内出现过两次。停用致病药物后进行水负荷试验时，未观察到利尿或血管加压素（AVP）血浆水平的抑制。在利钠过程中观察到肾素-醛固酮系统受抑制以及心房利钠肽（ANP）血浆水平降低。水负荷后AVP血浆水平升高。限制水摄入可改善症状并减轻低钠血症。这些发现表明，NSAID或氯丙嗪在八年内两次导致明显的SIAD。在该病例中，水负荷试验本身刺激了AVP的释放，并且肾素-醛固酮系统的抑制在利钠过程中比ANP发挥了更重要的作用。
