Hyponatremia in a patient with chronic inflammatory disease.
A 66-year-old man was admitted with destructive arthropathy, and calcium pyrophosphate dihydrate was demonstrated in the synovial fluid specimen. He was found to have a hyponatremia. The serum sodium concentration was 121 mmol/l, plasma arginine vasopressin (AVP) 6.6 pmol/l, and serum interleukin (IL)-6 96 pg/l. The clinical findings suggest the diagnosis of syndrome of inappropriate secretion of antidiuretic hormone (SIADH). However, destructive arthropathy with increased values of C-reactive protein and IL-6 is the only background of SIADH in this patient. We suggest the possibility that IL-6 produced at inflammatory lesions may have stimulated an excessive release of AVP resulting in the hyponatremia and hypochloremia of SIADH.
Murakami
T
T
Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital.
Matoba
H
H
Kuga
Y
Y
Ozawa
S
S
Kubota
K
K
Yoshida
S
S
D000368:Aged; D001127:Arginine Vasopressin / Q000097:blood / Q000378:metabolism*; D001168:Arthritis / Q000150:complications* / Q000503:physiopathology; D002097:C-Reactive Protein / Q000032:analysis; D002131:Calcium Pyrophosphate / Q000032:analysis; D002908:Chronic Disease; D006801:Humans; D007010:Hyponatremia / Q000209:etiology*; D007177:Inappropriate ADH Syndrome / Q000209:etiology*; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D013582:Synovial Fluid / Q000737:chemistry
D015850:Interleukin-6; D001127:Arginine Vasopressin; D002097:C-Reactive Protein; D002131:Calcium Pyrophosphate