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KMID : 0374920140350010161
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Inje Medical Journal
2014 Volume.35 No. 1 p.161 ~ p.165
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A Case of Syndrome of Inappropriate Antidiuretic Hormone in Therapy with Pioglitazone
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Ong Sung-Moon
Kim Byeong-Woo
Moon Seok-Jun
Shin Ho-Cheol
Yang Ju-Il
Lee Ho-Young
KIm Tae-Hee
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Abstract
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A 52-year-old woman presented to the emergency department because of general weakness. She had a past medical history of pre-dialysis chronic kidney disease, hypothyroidism and type 2 diabetes mellitus. Laboratory tests showed hyponatremia (109mEq/L) with a low serum osmolality (255mOsm/kg) and urine sodium level was 42 mEq/L. Patient was a euvolemic state and had no neurologic deficit on physical examination. She recently added pioglitazone for 1 month because of impaired glucose control and her serum sodium level was 132mEq/L before starting pioglitazone. Infusion of hypertonic saline was ineffective and clinical history suggested SIADH caused by pioglitazone therapy. After withdrawal of pioglitazone, she was treated with infusion of normal saline for 2 day. The patient's sodium concentration increased gradually and symptoms are improved. Her serum sodium rose to 135 mmol/L within 5 day and she was discharged.
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KEYWORD
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Pioglitazone, Hyponatremia, Syndrome of inappropriate antidiuretic hormone secretion
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