Jacobs R S
Am J Hosp Pharm. 1977 Oct;34(10):1140-2.
A case of a 76-year-old man with the syndrome of inappropriate secretion of antidiuretic hormone (ADH) is discussed. The patient was initially treated with fluid restriction followed by the administration of hypertonic saline. After failure to achieve rapid correction of the condition and continued lethargy and muscle weakness in the patient, a trial with lithium carbonate 300 mg three times daily via nasogastric tube was initiated. This resulted in a prompt reversal of the hyperosmolar state and improvement in electrolyte balance. However, despite the apparent success in treating his inappropriate ADH, the patient expired as a result of a massive cerebral vascular accident. The potential benefit of using lithium in the treatment of the syndrome of inappropriate secretion of ADH, and possible mechanisms of action, are reviewed.
本文讨论了一例76岁患有抗利尿激素分泌不当综合征（SIADH）的男性患者。患者最初接受限液治疗，随后给予高渗盐水。在未能迅速纠正病情且患者持续嗜睡和肌肉无力后，开始经鼻胃管每日三次给予300毫克碳酸锂进行试验。这导致高渗状态迅速逆转，电解质平衡得到改善。然而，尽管在治疗其抗利尿激素分泌不当方面看似取得成功，但患者因大面积脑血管意外而死亡。本文回顾了使用锂治疗抗利尿激素分泌不当综合征的潜在益处及可能的作用机制。
