title: Syndrome of inappropriate antidiuretic hormone secretion in patients with aquaporin-4 antibody.
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.
authors.affiliation: Department of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, 250# Changgang East Road, Guangzhou, 510260, Guangdong, China.
authors.forename: Shuxiang
authors.initials: S
authors.lastname: Pu
authors.forename: Youming
authors.initials: Y
authors.lastname: Long
authors.forename: Ning
authors.initials: N
authors.lastname: Yang
authors.forename: Yihua
authors.initials: Y
authors.lastname: He
authors.forename: Fulan
authors.initials: F
authors.lastname: Shan
authors.forename: Yongxiang
authors.initials: Y
authors.lastname: Fan
authors.forename: Jianrui
authors.initials: J
authors.lastname: Yin
authors.forename: Qingchun
authors.initials: Q
authors.lastname: Gao
authors.forename: Gao
authors.initials: G
authors.lastname: Cong
mesh_terms: D000328:Adult; D051401:Aquaporin 4 / Q000276:immunology*; D001323:Autoantibodies / Q000097:blood / Q000134:cerebrospinal fluid; D005260:Female; D057809:HEK293 Cells; D006801:Humans; D007031:Hypothalamus / Q000473:pathology*; D007177:Inappropriate ADH Syndrome / Q000276:immunology / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009471:Neuromyelitis Optica / Q000276:immunology / Q000473:pathology*; D055815:Young Adult
chemical_list: C496030:AQP4 protein, human; D051401:Aquaporin 4; D001323:Autoantibodies