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Journal of Neurology

, Volume 262, Issue 1, pp 101–107 | Cite as

Syndrome of inappropriate antidiuretic hormone secretion in patients with aquaporin-4 antibody

  • Shuxiang Pu
  • Youming Long
  • Ning Yang
  • Yihua He
  • Fulan Shan
  • Yongxiang Fan
  • Jianrui Yin
  • Qingchun Gao
  • Gao Cong
Original Communication

Abstract

The objective of this study was to analyze the frequency of syndrome of inappropriate antidiuretic hormone secretion (SIADH) in patients with positive aquaporin-4 (AQP4) antibodies and evaluate the relationship between SIADH and hypothalamic lesions in patients with NMO and NMO spectrum disorder (NMOSD). AQP4 antibodies were tested by an indirect immunofluorescence assay employing HEK-293 cells transfected with recombinant human AQP4. Clinical data of patients were analyzed retrospectively. In total, 192 patients with AQP4 antibodies were certified, of which 41 patients (21.4 %) were included in the present study. Six patients (14.6 %, 6/41) met the criteria of SIADH, of which hyponatremia was mild in one patient, and severe in five. Five patients experienced confusion or decreased consciousness. Four patients were diagnosed with NMO and two were diagnosed with recurrent optic neuritis. Magnetic resonance imaging showed 11 of 41 patients (26.8 %) had hypothalamic lesions. All patients with SIADH had hypothalamic abnormalities. Hyponatremia resolved in all patients after intravenous methylprednisolone and intravenous immunoglobulin therapy. SIADH is not rare in patients with NMO/NMOSD, especially in patients with lesions close to the hypothalamus.

Keywords

Aquaporin-4 Neuromyelitis optica Multiple sclerosis Syndrome of inappropriate antidiuretic hormone secretion 

Notes

Acknowledgments

This project was supported by Guangdong Natural Science Foundation (S2013010016262), the Science and Technology plan project of Guangdong Province (2012B031800240).

Conflicts of interest

The authors declare that no competing interests exist.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Shuxiang Pu
    • 1
    • 2
  • Youming Long
    • 1
    • 2
  • Ning Yang
    • 3
  • Yihua He
    • 1
    • 2
  • Fulan Shan
    • 1
    • 2
  • Yongxiang Fan
    • 1
    • 2
  • Jianrui Yin
    • 1
    • 2
  • Qingchun Gao
    • 1
    • 2
  • Gao Cong
    • 1
    • 2
  1. 1.Department of NeurologyThe Second Affiliated Hospital of Guangzhou Medical UniversityGuangzhouChina
  2. 2.Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of ChinaInstitute of Neuroscience and the Second Affiliated Hospital of Guangzhou Medical UniversityGuangzhouChina
  3. 3.Department of NeurologyThe Fifth Affiliated Hospital of Guangzhou Medical UniversityGuangzhouChina

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