Eosinophilic granulomatosis with polyangiitis as a rare cause of the syndrome of inappropriate antidiuretic hormone secretion.
Churg-Strauss syndrome
Eosinophilic granulomatosis with polyangiitis (EGPA)
Hyponatremia
The syndrome of inappropriate antidiuretic hormone secretion (SIADH)
Journal
Irish journal of medical science
ISSN: 1863-4362
Titre abrégé: Ir J Med Sci
Pays: Ireland
ID NLM: 7806864
Informations de publication
Date de publication:
Jun 2023
Jun 2023
Historique:
received:
23
05
2022
accepted:
19
07
2022
medline:
12
6
2023
pubmed:
28
7
2022
entrez:
27
7
2022
Statut:
ppublish
Résumé
Eosinophilic granulomatosis with polyangiitis (EGPA, Churg-Strauss syndrome) is a rare multisystem necrotizing vasculitis that involves small- to medium-sized blood vessels. We report a rare case of syndrome of the inappropriate antidiuretic hormone (ADH) secretion (SIADH) secondary to EGPA. A 53-year-old man applied with complaints of pain in the large joints and morning stiffness in knee for 2 months. The patient had the history of impaired fasting glucose, asthma, nasal polyps, and urticaria. Physical examination revealed intrinsic muscle atrophy and weakness in the right hand. Peripheral eosinophil count was 9.78 × 109/L (0.02-0.5), erythrocyte sedimentation rate 39 mm/h (0-20), and C-reactive protein 5.77 mg/dL (0-0.5). Migratory ground-glass pulmonary opacities had been reported in previous chest computed tomography scans. Echocardiography revealed findings compatible with eosinophilic involvement. Electroneuromyographic evaluation showed acute distal axonal neuropathy of right ulnar nerve. EGPA was considered. Oral methylprednisolone treatment was initiated. Intravenous immunoglobulin (IVIG) and cyclophosphamide treatment and gradual tapering of oral steroids were planned. In 24-h urine analysis, sodium was 387 mEq, creatinine was 1156 mg, and volume was 3000 mL. When his medical records were investigated, it was observed that hyponatremia was present for nearly 2 years. While serum osmolality was 270, urine osmolality was 604 mOsm/kg H
Identifiants
pubmed: 35895178
doi: 10.1007/s11845-022-03107-6
pii: 10.1007/s11845-022-03107-6
doi:
Substances chimiques
Immunoglobulins, Intravenous
0
Methylprednisolone
X4W7ZR7023
Vasopressins
11000-17-2
Cyclophosphamide
8N3DW7272P
Types de publication
Case Reports
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
1171-1176Informations de copyright
© 2022. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.
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