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The Korean Journal of Medicine 2008;74(1): 84-89.
利앸 : 媛꾩븫뿉 쓽븳 빆씠눊 샇瑜대が 遺꾨퉬 씠긽 利앺썑援 1삁
源踰붽꼍, 理쒗삙吏, 쟾븳샇, 떊긽쑄, 씠쁺二, 젙닔吏, 쑀궡異
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
怨좊젮븰援 쓽怨쇰븰 궡怨쇳븰援먯떎
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 patient셲 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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