The syndrome of inappropriate secretion of anti-diuretic hormone (SIADH) and brucellosis


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Bala K. A., Doğan M., Kaba S., Akbayram S., Aslan O., Kocaman S., ...More

Medical Science Monitor, vol.22, pp.3129-3134, 2016 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 22
  • Publication Date: 2016
  • Doi Number: 10.12659/msm.899977
  • Journal Name: Medical Science Monitor
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.3129-3134
  • Keywords: Adolescent, Brucellosis, Child, Inappropriate ADH syndrome
  • Ankara Yıldırım Beyazıt University Affiliated: No

Abstract

Background: Our study aimed to demonstrate the frequency of the syndrome of inappropriate ADH secretion (SIADH) and associated factors during the course of brucellosis in children and adolescents. Material and Methods: The study included children and adolescents aged 0-18 years old diagnosed with brucellosis between 2012 and 2014. The data were collected from patient charts. The diagnosis of brucellosis was made based on titrations >1:160 in standard Wright tube agglutination tests and/or positive culture tests. SIADH diagnosis was made based on the following criteria: euvolemic hyponatremia, serum Na+ <135 mmol/L, presence of serum hypoosmolarity (serum osmolarity <275 mOsm/L), increased urinary sodium (>25 mmol/L with normal dietary salt intake), low uric acid (<2 mg/dL), absence of kidney, thyroid or adrenal disease, and any anti-diuretic use. Results: The study included 160 children and adolescents with mean age of 9.58±3.95 years (range: 2-18 years) including 70 girls (43.8%) and 90 boys (56.2%). When the patients were stratified based on SIADH, it was found that SIADH was present in 35 patients (21.9%). SIADH was associated with elevated glucose (p<0.001), ALT (p<0.05), AST (p<0.05), LDH (p<0.001), CRP (p<0.001), and MPV (p<0.001); and decreased potassium (p<0.05), chloride (p<0.001), albumin (p<0.001), total protein (p<0.05), and hemoglobin (p<0.05) levels. Conclusions: Our study reports on the frequency, clinical characteristics, predisposing factors, and management of SIADH that can develop in children and adolescents diagnosed with brucellosis.