Brief Answer:
all relevant details for SIADH are below.

Detailed Answer:
Hello and welcome to Ask A Doctor services.
I have read your query with attached reports and here is my advise.

* As per my clinical experience, Syndrome of Inappropriate Antidiuretic
Hormone secretion is condition during which the body secrets ADH
irrespective of need and hence there is abnormal fluid retention in the
body.

* There are many causes of SIADH, common among them are

- Drug induced as loop diuretics, anti depressant medications as selective
serotonin reuptake inhibitors
- Head injuries
- Congestive heart failure
- Endocrine deficiencies
- Chest conditions such as pneumonia, lung tumors with ADH secretion
- Others

* The prognosis depends upon the underlying cause which is reversible or
irreversible, severity of the symptoms, body response to management and
associated comorbid conditions such as diabetes, hypertension and others.

* The complications occur in acute set up where there is severe low levels of
sodium called hyponatremia leading to central nervous system symptoms
of dizziness and may end up in coma.

* Poor prognosis or bad outcome happens in cases of severe infection states
such as sepsis and respiratory failure.

* With recent advances in management of SIADH, there are excellent results
in control of acute phases as well as chronic conditions of SIADH.

@ First and foremost criteria is fluid and water restriction, which should be
500 - 1000 ml per day depending upon the clinical evaluation.
@ Hypertonic saline depending upon the sodium levels.

@ Stopping possible offending agents such as diuretics, anti depressants in
form of selective serotonin reuptake inhibitors
@ Demeclocycline in refractory hyponatremia

@ Newer emergence of Vasopressin antagonists such as Vaptans are
specifically directed therapy with good prospects in chronic hyponatremia
issues.
@ Surgery comes into consideration, where there is resectable mass causing
the ADH release such as lung tumor or others.

However, every case is different depending upon the cause, individual body response and other factors.

Would like to address further as per your queries ahead in this regard with particular answers as needed from my side.

1. Duration of your diagnosis.
2. Prognosis since beginning after therapy.
3. Current complaints if any.
4. Lab data, radiology reports available ?

Awaiting for your response.
Regards.

Dr Bhagyesh ( MS consultant surgeon )

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Brief Answer:
follow up.

Detailed Answer:
Hi
Thanks for the additional information of surgery in 2015 for bladder neck incision and laboratory tests.

* The narration of recurrent hypernatremia is mentioned, but there is no
report of serum sodium or serum ADH level found in these attachments.

* When the symptoms are well controlled under medications, urine flow is
alright and creatinine is fine, there are not seeming short term possible
complications from SIADH.

Awaiting for your response.
Regards.

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