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首页> 外文期刊>P & T: a peer-reviewed journal for formulary management >Amiodarone-Induced Syndrome of Inappropriate Antidiuretic Hormone: A Case Report and Review of the Literature.
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Amiodarone-Induced Syndrome of Inappropriate Antidiuretic Hormone: A Case Report and Review of the Literature.

机译：胺碘酮诱导的不适当性抗毒素激素的综合征：文献的案例报告和审查。

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摘要

Amiodarone (Cordarone~(?), Pfizer Inc) is an antiarrhythmic medication with a well-known toxicity profile, including rare cases of hyponatremia as a result of syndrome of inappropriate antidiuretic hormone (SIADH). We report on such a case in which a patient was found to be hyponatremic after evaluation. An 88-year-old male who presented to the emergency department was found to be hyponatremic secondary to amiodarone-induced SIADH following a fall, with possible seizure and traumatic brain injury. He had a history of hypertension, paroxysmal atrial fibrillation, emphysema, myocardial infarction, benign prostatic hyperplasia, chronic kidney disease, Meniere's disease, anemia, and gastroesophageal reflux. Upon admission, his urine sodium level was elevated, and his serum sodium, urine osmolality, and anion gap were below normal. In the setting of hyponatremia, the patient's amiodarone was held: he had been taking amiodarone 200 mg once daily for nine months prior to admission. He was treated with intravenous (IV) normal saline over four days. He was fluid-restricted and his sodium levels were closely monitored every two hours. Within 19 hours, his serum sodium levels had improved. Amiodarone was restarted approximately three days later. Upon follow-up after discharge, the patient remained on amiodarone for the next two months. His serum sodium level ranged from 126 mEq/L to 131 mEq/L over a two-week period. He was supplemented with sodium chloride tablets and has been otherwise stable. Amiodarone may cause acute or chronic SIADH, with a wide range of symptoms. Seizures have not been reported in the literature but our patient had a witnessed seizure, although his electroencephalogram (EEG) was negative. Syndrome of inappropriate antidiuretic hormone can occur with any formulation of amiodarone in a dose-dependent fashion. Our patient's sodium levels stabilized within two weeks after amiodarone was resumed. The mechanism of amiodarone-induced SIADH remains unclear.
机译：胺碘酮（Corkarone〜（？），Pfizer Inc）是一种具有众所周知的毒性剖面的抗心律失常药物，包括由于不适当的抗性激素（SIADH）的综合征而罕见的低钠血症病例。我们报告了这种情况，其中在评估后发现病人是低管的。一个88岁的男性被发现患有急诊部的低血压次级患者患有低血基诱导的SIADH后，可能癫痫发作和创伤性脑损伤。他患有高血压，阵发性心房颤动，肺气肿，心肌梗死，良性前列腺增生，慢性肾病，脑膜炎，贫血和胃食管反流。入院后，他的尿液钠水平升高，他的血清钠，尿液渗透压和阴离子间隙低于正常。在低钠血症的设置中，患有患者的胺碘酮：他在入院前九个月每天服用胺碘酮200毫克。他在四天内用静脉注射（IV）生理盐水治疗。他被流体限制，他的钠水平每两小时密切监测。在19小时内，他的血清钠水平改善了。大约三天后胺碘酮重新启动。在出院后随访后，患者在未来两个月内留在胺碘酮上。他的血清钠水平超过了两周期的126 Meq / L至131 Meq / L。他用氯化钠片补充，另有稳定。胺碘酮可能导致急性或慢性SIADH，具有广泛的症状。癫痫发作尚未在文献中报告，但我们的患者有一个见证的癫痫发作，尽管他的脑电图（脑电图）是阴性的。不适当的抗硫酸激素的综合征可以在剂量依赖的方式中与胺碘酮的任何配方发生。在恢复胺碘酮后两周内，我们患者的钠水平稳定。胺碘酮诱导的SIADH的机制仍不清楚。

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