Ectopic ADH secretion

Answer 1

Definition

Antidiuretic hormone (ADH), or vasopressin, is a substance produced naturally by the hypothalamus and released by the pituitary gland. The hormone controls the amount of water your body removes.

Ectopic ADH secretion is the release of ADH from an abnormal location within the body. Ectopic means "out of place."

Alternative Names

SIADH; Syndrome of inappropriate antidiuretic hormone secretion

Causes, incidence, and risk factors

The most common cause of ectopic ADH secretion is cancer. Certain lung cancers, as well as some head and neck tumors, are the most common cancers that cause this problem. In rare cases, many other tumors may cause ectopic ADH secretion.

See also:

• ADH test

Symptoms

The abnormal release of ADH makes it harder for the body to remove water. Fluid builds up in the body. Low blood sodium levels (hyponatremia) can occur.

Often, there are no symptoms from low sodium levels. However, changes in mental status and even seizures may occur.

Treatment

Treatment is aimed at removing the cause of the problem (for example, surgery to remove a tumor producing ADH).

Limiting fluid intake is another common treatment. This helps prevent excess water from building up in the body.

Patients in the hospital with ectopic ADH that does not respond to other treatments may be given tolvaptan by mouth (orally) and conivaptan through a vein (intravenous). These treatments block the effects of ADH.

References

Lin M, Liu SJ, Lim IT. Disorders of water imbalance. Emerg Med Clin North Am. 2005;23(3):749-770.

Gagel RF. Endocrine manifestations of tumors: "ectopic" hormone production. In: Goldman L, Ausiello D, eds. Cecil Medicine. Philadelphia, PA: Saunders; 2007:chap 188.

Answer 2

Definition

Ectopic ADH secretion is the release of Antidiuretic hormone (ADH), or vasopressin, from an abnormal place in the body. ADH is a substance produced naturally by the hypothalamus and released by the pituitary gland. This hormone controls the amount of water your body removes.

Ectopic means "out of place."

Alternative Names

SIADH; Syndrome of inappropriate antidiuretic hormone secretion

Causes, incidence, and risk factors

The most common cause of ectopic ADH secretion is cancer. Certain lung cancers, as well as some head and neck tumors, are the most common cancers that cause this problem. In rare cases, many other tumors may cause ectopic ADH secretion.

See also:

• ADH test

Symptoms

The abnormal release of ADH makes it harder for the body to remove water. Fluid builds up in the body. Low blood sodium levels (hyponatremia) can occur.

Often, there are no symptoms from low sodium levels. However, changes in mental status and even seizures may occur.

Treatment

Treatment is aimed at removing the cause of the problem (for example, surgery to remove a tumor producing ADH).

Limiting fluid intake is another common treatment. This helps prevent excess water from building up in the body.

Patients in the hospital with ectopic ADH that does not respond to other treatments may be given tolvaptan by mouth (orally) and conivaptan through a vein (intravenous). These treatments block the effects of ADH.

References

Stewart PM, Krone NP. The adrenal cortex. In: Kronenberg HM, Melmed S, Polonsky KS, Larsen PR, eds. Williams Textbook of Endocrinology. 12th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 15.

Reviewed By

Review Date: 12/11/2011

Nancy J. Rennert, MD, Chief of Endocrinology & Diabetes, Norwalk Hospital, Associate Clinical Professor of Medicine, Yale University School of Medicine, New Haven, CT. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.