title: Severe hyponatremia due to rosiglitazone use in an elderly woman with diabetes mellitus: a rare cause of syndrome of inappropriate antidiuretic hormone secretion.
abstract: OBJECTIVE
  To describe the first case of syndrome of inappropriate antidiuretic hormone secretion with life-threatening hyponatremia due to rosiglitazone therapy.
  
  
  METHODS
  We describe the clinical, laboratory, and imaging findings of the study patient.
  
  
  RESULTS
  An 89-year-old woman with a 5-year history of type 2 diabetes mellitus was admitted to the emergency department because of unconsciousness. She had reported generalized weakness for 15 days and nausea and vomiting for 3 days. Findings from laboratory analysis showed severe hyponatremia (sodium, 110 mEq/L). She had normal renal, cardiac, and adrenal function, and she did not have edema or volume depletion. The cause of hyponatremia was syndrome of inappropriate antidiuretic hormone secretion. We did not find any cause for her condition other than rosiglitazone, an antihyperglycemic drug that is increasingly being used in patients with type 2 diabetes mellitus. According to her medical history, rosiglitazone was prescribed 1 month previously after withdrawal of gliclazide. We stopped the rosiglitazone and administered hypertonic saline infusion to treat the hyponatremia. Saline infusion was stopped and blood sodium levels were stabilized in the normal range after 2 days. The patient's plasma sodium concentration has remained in the reference range at follow-up visits.
  
  
  CONCLUSIONS
  This is the first reported case of syndrome of inappropriate antidiuretic hormone secretion as an adverse effect of rosiglitazone, and this drug should possibly be considered for addition to the list of drugs that cause this condition.
authors.affiliation: Department of Endocrinology and Metabolism, Numune Research and Training Hospital, Ankara, Turkey. dberker6@yahoo.com
authors.forename: Dilek
authors.initials: D
authors.lastname: Berker
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Aydin
authors.forename: Ayşe
authors.initials: A
authors.lastname: Arduç
authors.forename: Ihsan
authors.initials: I
authors.lastname: Ustün
authors.forename: Bilal
authors.initials: B
authors.lastname: Ergün
authors.forename: Serdar
authors.initials: S
authors.lastname: Guler
mesh_terms: D000369:Aged, 80 and over; D003920:Diabetes Mellitus / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D007010:Hyponatremia / Q000139:chemically induced* / Q000503:physiopathology; D007177:Inappropriate ADH Syndrome / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D000077154:Rosiglitazone; D045162:Thiazolidinediones / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D007004:Hypoglycemic Agents; D045162:Thiazolidinediones; D000077154:Rosiglitazone