PMID- 35895178
OWN - NLM
STAT- MEDLINE
DCOM- 20230612
LR  - 20230612
IS  - 1863-4362 (Electronic)
IS  - 0021-1265 (Linking)
VI  - 192
IP  - 3
DP  - 2023 Jun
TI  - Eosinophilic granulomatosis with polyangiitis as a rare cause of the syndrome of 
      inappropriate antidiuretic hormone secretion.
PG  - 1171-1176
LID - 10.1007/s11845-022-03107-6 [doi]
AB  - 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 x 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(2)O. So, SIADH diagnosis was made. Fluid intake was restricted. Although the 
      patient's sodium level did not return to normal, it rose up to 130 mEq/L. After 
      second cycle of EGPA treatment (cyclophosphamide and IVIG), serum sodium was 
      normal. There is only four other documented cases of SIADH associated with EGPA. 
      We hypothesized that blood supply to the hypothalamus and/or posterior hypophysis 
      might be affected from EGPA vasculitis. Here, in this case, with effective 
      treatment of EGPA, SIADH was resolved which implies a causality between two 
      conditions.
CI  - (c) 2022. The Author(s), under exclusive licence to Royal Academy of Medicine in 
      Ireland.
FAU - Dellal, Fatma Dilek
AU  - Dellal FD
AUID- ORCID: 0000-0003-0755-4543
AD  - Department of Endocrinology and Metabolism, Ankara City Hospital, Ankara, Turkey. 
      drdellal@yahoo.com.
FAU - Karaahmetli, Gulsum
AU  - Karaahmetli G
AUID- ORCID: 0000-0002-5883-3545
AD  - Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara Yildirim 
      Beyazit University, Ankara, Turkey.
FAU - Guven, Serdar Can
AU  - Guven SC
AUID- ORCID: 0000-0003-1965-9756
AD  - Department of Rheumatology, Ankara City Hospital, Ankara, Turkey.
FAU - Aydin, Cevdet
AU  - Aydin C
AUID- ORCID: 0000-0003-2081-2885
AD  - Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara Yildirim 
      Beyazit University, Ankara, Turkey.
FAU - Topaloglu, Oya
AU  - Topaloglu O
AUID- ORCID: 0000-0003-2501-935X
AD  - Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara Yildirim 
      Beyazit University, Ankara, Turkey.
FAU - Ersoy, Reyhan
AU  - Ersoy R
AUID- ORCID: 0000-0002-7437-1176
AD  - Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara Yildirim 
      Beyazit University, Ankara, Turkey.
FAU - Cakir, Bekir
AU  - Cakir B
AUID- ORCID: 0000-0001-7526-8827
AD  - Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara Yildirim 
      Beyazit University, Ankara, Turkey.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Review
DEP - 20220727
PL  - Ireland
TA  - Ir J Med Sci
JT  - Irish journal of medical science
JID - 7806864
RN  - 0 (Immunoglobulins, Intravenous)
RN  - X4W7ZR7023 (Methylprednisolone)
RN  - 11000-17-2 (Vasopressins)
RN  - 8N3DW7272P (Cyclophosphamide)
SB  - IM
MH  - Male
MH  - Humans
MH  - Middle Aged
MH  - *Churg-Strauss Syndrome/complications/diagnosis/drug therapy
MH  - *Granulomatosis with Polyangiitis/complications/diagnosis
MH  - *Inappropriate ADH Syndrome/complications
MH  - Immunoglobulins, Intravenous
MH  - Methylprednisolone
MH  - Vasopressins
MH  - Cyclophosphamide/therapeutic use
OTO - NOTNLM
OT  - Churg-Strauss syndrome
OT  - Eosinophilic granulomatosis with polyangiitis (EGPA)
OT  - Hyponatremia
OT  - The syndrome of inappropriate antidiuretic hormone secretion (SIADH)
EDAT- 2022/07/28 06:00
MHDA- 2023/06/12 06:42
CRDT- 2022/07/27 11:57
PHST- 2022/05/23 00:00 [received]
PHST- 2022/07/19 00:00 [accepted]
PHST- 2023/06/12 06:42 [medline]
PHST- 2022/07/28 06:00 [pubmed]
PHST- 2022/07/27 11:57 [entrez]
AID - 10.1007/s11845-022-03107-6 [pii]
AID - 10.1007/s11845-022-03107-6 [doi]
PST - ppublish
SO  - Ir J Med Sci. 2023 Jun;192(3):1171-1176. doi: 10.1007/s11845-022-03107-6. Epub 
      2022 Jul 27.