Syndrome of Inappropriate Antidiuretic Hormone Secretion Associated with Amyotrophic Lateral Sclerosis in a Patient Developing Carbon Dioxide Narcosis

• Published in: Internal Medicine Vol. 56; no. 7; pp. 797 - 803
• Main Authors: Inoue, Yui, Murakami, Takaaki, Nakamura, Takeshi, Morita, Kyohei, Kaneda, Daita, Nishino, Ichizo, Hayashi, Tetsuya, Shinoto, Yuya, Hatoko, Tomonobu, Kato, Tomoko, Yonemitsu, Shin, Muro, Seiji, Oki, Shogo
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01-01-2017; Japan Science and Technology Agency
• Subjects: Aged; ALS; Amyotrophic lateral sclerosis; Amyotrophic Lateral Sclerosis - complications; Carbon dioxide; Carbon Dioxide - adverse effects; Case Report; CO2 narcosis; Excretion; Humans; Hyponatremia; Hyponatremia - complications; Inappropriate ADH Syndrome - complications; Inert Gas Narcosis - complications; Internal medicine; Male; Narcosis; NPPV; Osmolar Concentration; respiratory failure; Secretion; SIADH; Sodium
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.56.7033

We report a rare case of syndrome of inappropriate antidiuretic hormone secretion (SIADH) associated with amyotrophic lateral sclerosis (ALS). A 69-year-old man was admitted to our hospital with sustained hyponatremia. Hyposmolality with elevated urinary osmolality and sodium excretion was observed, which indicated SIADH. The treatment for SIADH was challenging; the patient developed carbon dioxide narcosis, which led to the diagnosis of ALS. After the initiation of noninvasive positive-pressure ventilation, the patient's serum sodium concentration normalized and became stable. Thus, ALS should be recognized as a possible cause of SIADH in the clinical setting.