What Is ADH Hypersecretion Syndrome
Hypersecretion syndrome of antidiuretic hormone (ADH) is due to the continuous secretion of endogenous ADH or ADH-like substances caused by various reasons, which causes obstacles in water excretion, thus causing hyponatremia, water retention and related clinical manifestations.
What Is The Cause Of ADH Hypersecretion Syndrome
The most common reason is that ADH is synthesized and released autonomously by tumor tissues, which accounts for about 80% of the characteristics, mainly including lung oat cell carcinoma, pancreatic cancer, duodenal cancer and lymphoma. Other neuropathy, such as pneumonia, pulmonary tuberculosis and trauma, inflammation, tumor, which affect hypothalamus-neurohypophysis function, can also cause ADH hypersecretion.
What Are The Symptoms Of ADH Hypersecretion Syndrome
In addition to the manifestation of primary disease, the main manifestations of this syndrome are water retention and hyponatremia. Generally, the serum sodium is lower than 130 mmol/L. When the serum sodium is lower than 120 mmol/L, weakness, loss of appetite, nausea and vomiting, lethargy, irritability and even mental disorder occur. Convulsion, coma and even death occur when blood sodium is less than 110 mmol/L. Because water retention generally does not exceed 3-4 liters, and part of water is transferred to cells, there is generally no edema.
1. Hyponatremia, generally lower than 130mmol/L, but increased urinary sodium, often more than 20mmol/L.
2. Urine osmotic pressure is higher than plasma osmotic pressure.
3. There was no hypovolemia.
4. Strict restriction of water inflow can correct low blood sodium, low plasma osmotic pressure and high urine sodium.
5. The manifestation of the primary disease can be found.
How To Check For ADH Hypersecretion Syndrome
Check that blood sodium is lower than 130mmol/L and urine sodium is higher than 20mmol/L.
How To Prevent ADH Hypersecretion Syndrome
Many endocrine diseases can be prevented, such as endemic goiter, postpartum hypofunction of anterior pituitary, chronic hypofunction of adrenal cortex caused by adrenal tuberculosis, thyroid crisis and so on. The treatment principle of endocrine diseases is to eradicate the etiology or correct the dysfunction and metabolic disorder caused by pathophysiology.
How To Treat ADH Hypersecretion Syndrome
In treatment, the mild patients only limit the daily intake of water to less than ＜100ml, the symptoms can be improved, the body weight is reduced, the serum sodium and osmotic pressure are increased, and the urine sodium discharge is reduced. In severe cases, 200-300ml of 5% sodium chloride solution should be instilled slowly, and the blood sodium should be gradually increased within a few hours, and furosemide can also be used for drainage. The application of anti-ADH drugs, such as norchlortetracycline, can prevent ADH from reabsorption of water in renal tubules. Lithium salt has similar effect, but it is more toxic. The most fundamental treatment for this disease is etiological treatment, and malignant tumor needs surgical resection, supplemented by radiotherapy and chemotherapy.
How To Identify ADH Hypersecretion Syndrome
This syndrome should be differentiated from water retention and/or hyponatremia caused by renal tubular diseases, hypoadrenocortical function, chronic heart failure, ascites due to cirrhosis, the application of hypertonic diuretics and hypothyroidism.