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Journal of Neurology
Published in: Journal of Neurology 1/2015

01-01-2015 | Original Communication

Syndrome of inappropriate antidiuretic hormone secretion in patients with aquaporin-4 antibody

Authors: Shuxiang Pu, Youming Long, Ning Yang, Yihua He, Fulan Shan, Yongxiang Fan, Jianrui Yin, Qingchun Gao, Gao Cong

Published in: Journal of Neurology | Issue 1/2015

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Abstract

The objective of this study was to analyze the frequency of syndrome of inappropriate antidiuretic hormone secretion (SIADH) in patients with positive aquaporin-4 (AQP4) antibodies and evaluate the relationship between SIADH and hypothalamic lesions in patients with NMO and NMO spectrum disorder (NMOSD). AQP4 antibodies were tested by an indirect immunofluorescence assay employing HEK-293 cells transfected with recombinant human AQP4. Clinical data of patients were analyzed retrospectively. In total, 192 patients with AQP4 antibodies were certified, of which 41 patients (21.4 %) were included in the present study. Six patients (14.6 %, 6/41) met the criteria of SIADH, of which hyponatremia was mild in one patient, and severe in five. Five patients experienced confusion or decreased consciousness. Four patients were diagnosed with NMO and two were diagnosed with recurrent optic neuritis. Magnetic resonance imaging showed 11 of 41 patients (26.8 %) had hypothalamic lesions. All patients with SIADH had hypothalamic abnormalities. Hyponatremia resolved in all patients after intravenous methylprednisolone and intravenous immunoglobulin therapy. SIADH is not rare in patients with NMO/NMOSD, especially in patients with lesions close to the hypothalamus.
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Metadata
Title
Syndrome of inappropriate antidiuretic hormone secretion in patients with aquaporin-4 antibody
Authors
Shuxiang Pu
Youming Long
Ning Yang
Yihua He
Fulan Shan
Yongxiang Fan
Jianrui Yin
Qingchun Gao
Gao Cong
Publication date
01-01-2015
Publisher
Springer Berlin Heidelberg
Published in
Journal of Neurology / Issue 1/2015
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-014-7537-y

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