Anne-Sophie Sejling1, Anne-Luise Thorsteinsson, Ulrik Pedersen-Bjergaard, Pia Eiken. 1. Department of Cardiology, Nephrology, and Endocrinology (A.-S.S., A.-L.T., U.P.-B., P.E.), Nordsjællands Hospital, DK-3400 Hillerød, Denmark; Faculty of Health Sciences (A.-S.S.), University of Southern Denmark, DK-5000 Odense, Denmark; and Faculty of Health Sciences (U.P.-B., P.E.), University of Copenhagen, DK-2200 Copenhagen, Denmark.
Abstract
INTRODUCTION: Recent studies show an association between hyponatremia and osteoporosis. We have previously reported a case of severe male osteoporosis due to chronic syndrome of inappropriate secretion of antidiuretic hormone (SIADH). Here, we provide a follow-up on this case after cure of the condition that further supports the causal relationship. THE CASE: A 38-year-old man had been diagnosed with severe osteoporosis most likely due to chronic SIADH. The SIADH was believed to be idiopathic. A magnetic resonance imaging scan, however, revealed a tumor in the sinus, and biopsies showed an esthesioneuroblastoma, immunohistochemically positive for antidiuretic hormone (ADH). After the tumor was removed, ADH and sodium levels normalized. A dual-energy x-ray absorptiometry scan performed 7 months after the patient's last surgery showed a significant spontaneous improvement in bone mineral density in the lumbar vertebrae. CONCLUSION: This case provides evidence for a causal relationship between SIADH and chronic hyponatremia and impaired bone metabolism that can lead to severe secondary osteoporosis. The effect on bone metabolism is at least partially reversible.
INTRODUCTION: Recent studies show an association between hyponatremia and osteoporosis. We have previously reported a case of severe male osteoporosis due to chronic syndrome of inappropriate secretion of antidiuretic hormone (SIADH). Here, we provide a follow-up on this case after cure of the condition that further supports the causal relationship. THE CASE: A 38-year-old man had been diagnosed with severe osteoporosis most likely due to chronic SIADH. The SIADH was believed to be idiopathic. A magnetic resonance imaging scan, however, revealed a tumor in the sinus, and biopsies showed an esthesioneuroblastoma, immunohistochemically positive for antidiuretic hormone (ADH). After the tumor was removed, ADH and sodium levels normalized. A dual-energy x-ray absorptiometry scan performed 7 months after the patient's last surgery showed a significant spontaneous improvement in bone mineral density in the lumbar vertebrae. CONCLUSION: This case provides evidence for a causal relationship between SIADH and chronic hyponatremia and impaired bone metabolism that can lead to severe secondary osteoporosis. The effect on bone metabolism is at least partially reversible.
Authors: B Fibbi; S Benvenuti; C Giuliani; C Deledda; P Luciani; M Monici; B Mazzanti; C Ballerini; A Peri Journal: Endocrine Date: 2015-06-21 Impact factor: 3.633
Authors: Rachel L Usala; Stephen J Fernandez; Mihriye Mete; Laura Cowen; Nawar M Shara; Julianna Barsony; Joseph G Verbalis Journal: J Clin Endocrinol Metab Date: 2015-06-17 Impact factor: 5.958