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Two cases of MND/ALS developing the syndrome of inappropriate secretion of antidiuretic hormone
K Arakawa1, T Nishio, N Sunohara
1Department of Neurology, National Center of Neurology and Psychiatry, Tokyo, Japan.
Abstract:
We report 2 autopsy-proven cases of motor neuron disease/amyotrophic lateral sclerosis (MND/ALS), who developed the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) prior to the respiratory failure. With respect to the underlying mechanisms of SIADH in the cases, we considered two factors; 1) dysfunction of the feedback system in ADH secretion via intrathoracic volume receptors caused by changes in intrathoracic circulation, and 2) primarily functional abnormalities in the limbic system which could influence hypothalamic osmoreceptors. It appears that SIADH can be followed by an exacerbation of respiratory dysfunction in MND/ALS.
Insights
Syndrome of inappropriate antidiuretic hormone secretion (SIADH) can precede respiratory failure in motor neuron disease/amyotrophic lateral sclerosis (MND/ALS). This may involve intrathoracic circulation changes or limbic system dysfunction, potentially worsening respiratory issues in MND/ALS patients.
Area of Science:
- Neurology
- Endocrinology
Background:
- Motor neuron disease/amyotrophic lateral sclerosis (MND/ALS) is a progressive neurodegenerative disorder.
- The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is a condition characterized by excessive antidiuretic hormone (ADH) release.
Observation:
- Two autopsy-proven cases of MND/ALS are presented.
- Both patients developed SIADH before experiencing respiratory failure.
Findings:
- SIADH in MND/ALS may stem from disrupted intrathoracic volume receptor feedback due to circulatory changes.
- Alternatively, SIADH could arise from limbic system functional abnormalities affecting hypothalamic osmoreceptors.
Implications:
- SIADH might exacerbate respiratory dysfunction in patients with MND/ALS.
- Understanding these mechanisms could inform clinical management and patient care for MND/ALS.