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The Korean Journal of Medicine 2008;74(1): 84-89.
증례 : 간암에 의한 항이뇨 호르몬 분비 이상 증후군 1예
김범경, 최혜진, 전한호, 신상윤, 이영주, 정수진, 유내춘
A case of syndrome of inappropriate antidiuretic hormone secretion (SIADH) secondary to hepatocellular carcinoma
Beom Kyung Kim, Hye Jin Choi, Han Ho Jeon, Sang Yun Shin, Young Joo Lee, Su Jin Jeong, Nae Choon Yoo
고려대학교 의과대학 내과학교실
ABSTRACT
Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is characterized by a state of arginine vasopressin excess in the absence of physiologic stimuli. Its manifestations include hyponatremia with hypotonic plasma, increased urine osmolality, sodium excretion, and euvolemic status with normal thyroid, adrenal, and renal function. We report the case of a 56-year-old male patient who was admitted for drowsiness that turned out to be caused by hyponatremia. On admission, laboratory results and physical examination led to a diagnosis of SIADH. The patient was a hepatitis B viral carrier, and serum alpha-fetoprotein was 6,598 ng/mL. A diagnosis of hepatocellular carcinoma was confirmed on liver spiral CT scan and hepatic arteriography, and the patient was ultimately diagnosed as having SIADH secondary to his tumor. After hypertonic saline infusion and fluid restriction, the patient’s mental status and hyponatremia were corrected. He underwent transarterial chemoinfusion and local radiotherapy for hepatocellular carcinoma and a metastatic lesion, respectively.
Keywords: Carcinoma; Hepatocellular; Inappropriate ADH Syndrome; Hyponatremia
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