All issues > Volume 30(9); 1987

Original Article

J Korean Pediatr Soc. 1987;30(9):1021-1028. Published online September 30, 1987.

Syndrome of Inappropriate Secretion of Antidiuretic Hormone(SIADH) in Acute Respiratory Diseases.

Young Jee KIm¹, Young Yull Koh¹, Jeong Kee Seo¹, Hung Ko Moon¹

¹Department of Pediatrics, College of Medicine, Seoul National University

Abstract

The SIADH incidence and relevant factors in acute respiratory diseases were evaluated in 461 children with over 28 days old, hospitalized for bronchiolitis, viral pneumonia, bacterial pneumonia, mycoplasma pneumonia and asthma, without other causes of electrolyte imbalance. The overall incidence of SIADH in acute respiratory diseases was 11.93%. The incidence in mycoplasma pneumonia (19.05%) was highest and incidence in bacterial pneumonia (17.42%), viral pneumonia (9.17%), bronchiolitis (7.69%), asthma (3.92%) were in sequence. The incidence in bacterial pneumonia was significantly higher than others except mycoplasma pneumonia, and over than half (56.36%) of etiologic diseases in SIADH patients was bacterial pneumonia, wherease the incidence in mycoplasma pneumonia was high but statistically not significant than others except asthma. The incidence of SIADH was not influenced by age nor sex, but affected by fever. The SIADH incidence in children with fever over than 39*C (22.39%) was significantly higher than children without fever. On arterial blood gas analysis between children with SIADH and chilren without SIADH, PaCO2 was not different, but PaO2 was significantly decreased in children with SIADH except mycoplasma pneumonia. Mean serum sodium concentrations in children with SIADH according to etiolgoic diseases were similar. Except two children presented with transient lethargy, other severe water intoxication symptoms were not noted even in children with less than 120 mEq/L of serum sodium concentration. In most cases, hyponatremia was corrected by fluid restriction only, but recovery in bacterial pneumonia was slower than others, and hyponatremia was corrected by furosemide and hypertonic solution in a few children with bacterial pneumonia. Therefore, we recommend the routine check of electrolyte in children with acute respiratory disease especially presented with high fever or hypoxemia.

Keywords :Syndrome of Inappropriate Secretion of Antidiuretic Hormone