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[Syndrome of inappropriate ADH secretion (SIADH) in small-cell bronchus carcinoma]

A von Rohr1, T Cerny, R A Joss

  • 1Institut für Medizinische Onkologie, Universität, Inselspital Bern.

Schweizerische Medizinische Wochenschrift
|September 7, 1991
PubMed

Insights

Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) is common in small cell lung cancer patients, often presenting subtly. Early detection and tumor treatment are key to managing SIADH and may utilize antidiuretic hormone (ADH) as a tumor marker.

Area of Science:

  • Endocrinology
  • Oncology
  • Nephrology

Context:

  • Small cell lung cancer (SCLC) is a neuroendocrine tumor.
  • SCLC can ectopically produce peptide hormones, including antidiuretic hormone (ADH).
  • Paraneoplastic SIADH is a recognized complication of SCLC.

Purpose:

  • To review the paraneoplastic syndrome of inappropriate antidiuretic hormone secretion (SIADH) in small cell lung cancer (SCLC).
  • To discuss the mechanisms, clinical presentation, incidence, and management of SIADH in SCLC patients.

Summary:

  • Paraneoplastic SIADH in SCLC can result from ectopic ADH production or other tumor-related mechanisms.
  • Clinically manifest SIADH occurs in approximately 4% of SCLC patients, with neurological symptoms due to cerebral edema.
  • Subclinical SIADH (hyponatremia, hypoosmolality, urine hyperosmolality) is more frequent (14%), with elevated ADH levels in 38% of patients.
  • Treatment involves addressing the underlying SCLC and fluid restriction; plasma ADH may serve as a tumor marker.

Impact:

  • Highlights the significant incidence of SIADH in SCLC, both overt and subclinical.
  • Emphasizes the role of ADH in SCLC pathogenesis and its potential as a tumor marker.
  • Informs clinical practice regarding the diagnosis and management of SIADH in SCLC patients.

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