139 0 0 0 OA SIADHを合併した新型コロナウイルス感染症の1例
- 著者
- 小泉 陽介 平岡 知子 西山 明 山領 豪 古本 朗嗣
- 出版者
- 一般社団法人 日本感染症学会
- 雑誌
- 感染症学雑誌 (ISSN:03875911)
- 巻号頁・発行日
- vol.96, no.6, pp.230-235, 2022-11-20 (Released:2022-11-21)
- 参考文献数
- 19
A 67-year-old Japanese woman with a history of contact with a COVID-19 patient presented with a one-day history of fever, malaise, and dyspnea, and was hospitalized with a positive nasopharyngeal swab test for SARS-CoV-2 LAMP. Chest CT revealed bilateral patchy infiltrates. The patient was treated with remdesivir and dexamethasone and supplemental oxygen supplied via a nasal cannula. The supplemental oxygen therapy was continued for 6 days, and the drug administration was completed on the 10th day of hospitalization. The patient was then scheduled to be discharged, when she developed severe hyponatremia with a serum Na level of 110 mEq/L, but no consciousness disorder.The patient was diagnosed as having SIADH after several examinations suggesting higher levels of secretion of antidiuretic hormone, with a higher specific gravity of the urine than that of the serum, in addition to evidence of normal functioning of the thyroid, adrenal, and pituitary glands, and of the liver and kidneys. Whole-body CT showed no evidence of any tumors. The hospitalization was extended for correcting the serum sodium levels by restriction of water intake. It was assumed that the SIADH was caused by COVID-19, presumably by the elevated serum IL-6 levels inducing secretion of ADH, similar to the phenomenon reported in other inflammatory diseases associated with elevated serum IL-6 levels.COVID-19 could lead to SIADH due of unresolved systemic inflammation even in the absence of worsening of the findings of chest imaging after the completion of antiviral treatments. Further studies are required to evaluate the correlation between the inflammatory state (e.g., serum concentration of IL-6) and serum ADH level causing hyponatremia during the clinical course of COVID-19.
言及状況
外部データベース (DOI)
Twitter (139 users, 143 posts, 550 favorites)
@Hana86057084 https://t.co/UXq8wnE6k9
探したら症例報告がありましたので添付します。「こういう患者さんがいた」という話なので、難しい内容ではないですし参考になるかも知れません。
J-STAGE Articles - SIADHを合併した新型コロナウイルス感染症の1例
(SIADH)
バソプレシン分泌過剰症
抗利尿ホルモン不適合分泌症候群
https://t.co/UNWOvdv7Mx
コロナ感染後にSIADH発症した患者さんがいる。精神科では向精神薬の副作用で薬剤性SIADHはよく診察する。
今回はドラッグフリーの患者さんだったので、半信半疑であったが、検査した結果、診断基準を満たした。
かなり驚いたが、すでに日本語で症例報告があった。
https://t.co/XJ2yvdpmZE