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Hillerød, Denmark

Sejling A.-S.,Endocrine Section 0652 | Sejling A.-S.,University of Southern Denmark | Thorsteinsson A.-L.,Endocrine Section 0652 | Pedersen-Bjergaard U.,Endocrine Section 0652 | And 3 more authors.
Journal of Clinical Endocrinology and Metabolism | Year: 2014

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.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. Adual-energy x-ray absorptiometry scan performed 7months after the patient's last surgery showed a significant spontaneous improvement in bone mineral density in the lumbar vertebrae.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. Copyright © 2014 by the Endocrine Society. Source


Sejling A.-S.,Endocrine Section 0652 | Pedersen-Bjergaard U.,Endocrine Section 0652 | Eiken P.,Endocrine Section 0652
Journal of Clinical Endocrinology and Metabolism | Year: 2012

Objective: Recent studies indicate an association between hyponatremia and osteoporosis. We report a clinical case that supports this statement. Case Report: A 36-yr-old man was diagnosed with the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) at the age of 22. In the years that followed, sodium levels in the blood remained low from 111-130 mmol/liter (137-144). At the age of 34, he was diagnosed with osteoporosis after a magnetic resonance imaging scan showed moderate compression fractures at Th9-11 and L2. A dual energy x-ray absorptiometry scan showed a Z-score of -3.9 at the lumbar spine (L3-L4) and a Z-score of -1.3 in the total hip. He had no other known risk factors for osteoporosis. Urinary excretion of calcium and sodium were elevated. Plasma vasopressin level was inappropriately elevated. One year after treatment with 5-mg zoledronic acid, there has been no significant change in the bone mineral density in the lumbar spine and a small increase in bone mineral density in the total hip. The symptoms from SIADH have not changed. Conclusion: The case illustrates that severe idiopathic SIADH and chronic hyponatremia can have severe side effects on bone metabolism and can lead to secondary osteoporosis. We support the recommendation that patients with chronic SIADH should be screened for osteoporosis and suggest that early bone protective treatment should be considered to reduce or delay osteoporosis onset. Copyright © 2012 by The Endocrine Society. Source

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