| Syndrome of Inappropriate Secretion of Antidiuretic Hormone(SIADH) in Acute Respiratory Diseases. |
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Young Jee KIm, Young Yull Koh, Jeong Kee Seo, Hung Ko Moon |
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Department of Pediatrics, College of Medicine, Seoul National University |
| 급성 호흡기 질환에서의 항이뇨호르몬 과다분비에 관한 연구 |
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김영지, 고영률, 서정기, 문형로 |
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서울대학교 의과대학 소아과학교실 |
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| Abstract |
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The SIADH incidence and relevant factors in acute respiratory diseases were evaluated in 461
children with over 28 days old, hospitalized for bronchiolitis, viral pneumonia, bacterial pneumonia,
mycoplasma pneumonia and asthma, without other causes of electrolyte imbalance.
The overall incidence of SIADH in acute respiratory diseases was 11.93%. The incidence in
mycoplasma pneumonia (19.05%) was highest and incidence in bacterial pneumonia (17.42%), viral
pneumonia (9.17%), bronchiolitis (7.69%), asthma (3.92%) were in sequence. The incidence in bacterial
pneumonia was significantly higher than others except mycoplasma pneumonia, and over than half
(56.36%) of etiologic diseases in SIADH patients was bacterial pneumonia, wherease the incidence in
mycoplasma pneumonia was high but statistically not significant than others except asthma.
The incidence of SIADH was not influenced by age nor sex, but affected by fever. The SIADH
incidence in children with fever over than 39*C (22.39%) was significantly higher than children without
fever. On arterial blood gas analysis between children with SIADH and chilren without SIADH,
PaCO2 was not different, but PaO2 was significantly decreased in children with SIADH except
mycoplasma pneumonia.
Mean serum sodium concentrations in children with SIADH according to etiolgoic diseases were
similar. Except two children presented with transient lethargy, other severe water intoxication
symptoms were not noted even in children with less than 120 mEq/L of serum sodium concentration.
In most cases, hyponatremia was corrected by fluid restriction only, but recovery in bacterial
pneumonia was slower than others, and hyponatremia was corrected by furosemide and hypertonic
solution in a few children with bacterial pneumonia.
Therefore, we recommend the routine check of electrolyte in children with acute respiratory
disease especially presented with high fever or hypoxemia.
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| Key Words:
Syndrome of Inappropriate Secretion of Antidiuretic Hormone |
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