(1) 원인
1 Bronchogenic cancer (m/c) and other cancer
2 Chemotherapy, Opioids, Carbamazepine, SSRI
(2) 증상
1 Hyponatremia
2 Low serum osmolality in euvolemia / Normal renal, adrenal, thyroid function
3 암환자가 normovolemic hyponatremia를 보인다면 Syndrome of inappropriate antidiuretic
hormone secretion을 의심해야 함
4 Anorexia, nausea, malaise - Earliest finding
5 Headache, Confusion, Obtundation, Seizure (GTC type), Coma
6 Life-threatening sx. 은 대게 sodium < 110mEq/L(<110mmol/L)에서 나타남
(3) 치료
1 Na+>125, Euvolemic asymptomatic : 수분 제한, 500mL/d
2 125>Na+>110
: Furosemide (0.5 to 1.0 mg/kg PO) with concomitant IV saline to maintain euvolemia
3 Na+<110, with coma or seizure
: 3% hypertonic saline (510 mEq/L), 25 to 100mL/h
: Avoid volume overload or rapid correction (central pontine myelinolysis)
:적절한Na+ 교정속도:시간당0.5to1.0mEq/L,하루에최대12to15mEq/L
