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Unusual association of diseases/symptoms
Case report
Syndrome of inappropriate antidiuretic hormone associated with eosinophilic granulomatosis and polyangiitis
  1. Michael S Lundin1,2,
  2. Beenu Kaw3 and
  3. Rajit Pahwa4
  1. 1Internal Medicine, Michigan State University, East Lansing, Michigan, USA
  2. 2Internal Medicine, Sparrow Hospital, Lansing, Michigan, USA
  3. 3Nephrology, Sparrow Hospital, Lansing, Michigan, USA
  4. 4Intensive Care and Neurointensive Care, Sparrow Hospital, Lansing, Michigan, USA
  1. Correspondence to Dr Michael S Lundin; makala.lundin{at}gmail.com

Abstract

A 62-year-old man presented with classic signs and symptoms of eosinophilic granulomatosis and polyangiitis (EGPA, also known as Churg-Strauss syndrome)—mononeuritis multiplex, palpable purpura, hypereosinophilia, positive P-ANCA (perinuclear anti-neutrophil cytoplasmic antibodies) developed diffuse alveolar haemorrhage. The patient had longstanding mild hyponatraemia, but developed moderate and symptomatic hyponatraemia characteristic of the syndrome of inappropriate antidiuretic hormone. The patient’s serum sodium returned to his baseline- mildly hyponatraemic, after initiation of treatment targeted towards EGPA.

  • adult intensive care
  • medical management
  • vasculitis
  • fluid electrolyte and acid-base disturbances
  • pituitary disorders

https://doi.org/10.1136/bcr-2019-231249

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    Footnotes

    • Contributors MSL is a senior internal medicine resident who wrote the manuscript. RP is the intensivist who took care of the patient and reviewed the manuscript. BK is the nephrologist who took care of the patient and reviewed the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.