抗利尿激素分泌不当综合征（SIADH）及与夏伊-德雷格综合征相关的格哈特综合征

Syndrome of inappropriate secretion of antidiuretic hormone (SIADH) and Gerhardt syndrome associated with Shy-Drager syndrome.

作者信息

Sone H, Okuda Y, Bannai C, Suzuki S, Yamaoka T, Asakura Y, Kawakami Y, Odawara M, Matsushima T, Kawai K

机构信息

Department of Endocrinology and Metabolism, University of Tsukuba.

出版信息

Intern Med. 1994 Dec;33(12):773-8. doi: 10.2169/internalmedicine.33.773.

DOI:10.2169/internalmedicine.33.773

PMID:7718959

Abstract

This is the first report on a case of syndrome of inappropriate secretion of antidiuretic hormone (SIADH) associated with Gerhardt syndrome (paralysis of bilateral vocal cords). A 67-year-old Japanese man suffering from progressive autonomic failure was diagnosed as having Shy-Drager syndrome (SDS) with hyponatremia due to SIADH and severe sleep apnea caused by a bilateral recurrent nerve palsy. Water load test showed alteration in diuresis which was corrected by phenytoin. Arginine vasopressin secretion was not suppressed by plasma osmolality below 280 mOsm/kgH2O. Impairment of the afferent pathways of baroreceptors, or impairment of the osmoreceptors could be speculated as the etiological factor of the SIADH observed in this case.

摘要

这是首例关于抗利尿激素分泌不当综合征（SIADH）合并格哈特综合征（双侧声带麻痹）的病例报告。一名67岁患有进行性自主神经功能衰竭的日本男性被诊断为夏伊-德雷格综合征（SDS），因SIADH导致低钠血症，且因双侧喉返神经麻痹引起严重睡眠呼吸暂停。水负荷试验显示利尿改变，苯妥英可纠正该改变。血浆渗透压低于280 mOsm/kgH2O时，精氨酸血管加压素分泌未被抑制。可推测压力感受器传入通路受损或渗透压感受器受损是该病例中观察到的SIADH的病因。