Murakami T, Matoba H, Kuga Y, Ozawa S, Kubota K, Yoshida S
Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital.
Intern Med. 1998 Sep;37(9):792-5. doi: 10.2169/internalmedicine.37.792.
A 66-year-old man was admitted with destructive arthropathy, and calcium pyrophosphate dihydrate was demonstrated in the synovial fluid specimen. He was found to have a hyponatremia. The serum sodium concentration was 121 mmol/l, plasma arginine vasopressin (AVP) 6.6 pmol/l, and serum interleukin (IL)-6 96 pg/l. The clinical findings suggest the diagnosis of syndrome of inappropriate secretion of antidiuretic hormone (SIADH). However, destructive arthropathy with increased values of C-reactive protein and IL-6 is the only background of SIADH in this patient. We suggest the possibility that IL-6 produced at inflammatory lesions may have stimulated an excessive release of AVP resulting in the hyponatremia and hypochloremia of SIADH.
一名66岁男性因破坏性关节病入院，滑膜液标本中检测到二水焦磷酸钙。他被发现患有低钠血症。血清钠浓度为121 mmol/l，血浆精氨酸加压素（AVP）为6.6 pmol/l，血清白细胞介素（IL）-6为96 pg/l。临床发现提示抗利尿激素分泌不当综合征（SIADH）的诊断。然而，在该患者中，伴有C反应蛋白和IL-6值升高的破坏性关节病是SIADH的唯一背景。我们认为，炎症病灶产生的IL-6可能刺激了AVP的过度释放，导致了SIADH的低钠血症和低氯血症。
