바터 팽대부 종양에 동반된 부적절 항이뇨호르몬 분비 증후군 (SIADH) 1예
A case of SIADH associated with carcinoma of the ampulla of Vater
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초록
부적절 항이뇨호르몬 분비 증후군(SIADH)은 저나트륨혈증을 보이는 환자의 흔한 원인이며, 악성 종양이 그 중요한 원인 중 하나이다. 저자들은 복통과 딸국질을 주소로 내원한 73세 남자 환자에서 SIADH를 진단하였으며, 그 원인으로 바터 팽대부 종양을 진단하여 치료하였기에 문헌고찰과 함께 보고하는 바이다.
Abstract
The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is one of the most common causes of hyponatremia and results from inappropriate release of antidiuretic hormone (ADH). SIADH may be caused by a variety of malignant tumors, including central nervous system disorders, intrathoracic disorders and various pharmacologic agents. We experienced a case of SIADH associated with carcinoma of the ampulla of Vater. A 73-year-old man was admitted to hospital with abdominal pain and hiccup. Laboratory findings showed that the serum sodium concentration and serum osmolarity were extremely low, while the urine sodium concentration and urine osmolarity were inappropriately high, and the patient was diagnosed with SIADH. Endoscopy showed an ill-defined nodular ampulla of Vater and a biopsy revealed a carcinoma. Resection of the ampullary carcinoma corrected the abnormal sodium levels and restored the laboratory findings to normal. The normal conditions have been continuous for 6 months. To our knowledge, this is the first case of SIADH caused by an ampullary carcinoma.(Korean J Med 72:415-419, 2007)
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