Asymptomatic meningitis diagnosed by positron emission tomography in a patient with syndrome of inappropriate antidiuretic hormone secretion: a case report

Journal of Medical Case Reports

Rieko Kunishita¹  Yu Togashi¹  Masanori Hasebe¹  Mayu Kyohara¹  Daisuke Miyashita¹  Yasuo Terauchi¹  Tomoko Okuyama¹  Jun Shirakawa² 

[1] Department of Endocrinology and Metabolism, Graduate School of Medicine, Yokohama City University, Yokohama, Japan;Department of Endocrinology and Metabolism, Graduate School of Medicine, Yokohama City University, Yokohama, Japan;Laboratory of Diabetes and Metabolic Disorders, Institute for Molecular and Cellular Regulation (IMCR), Gunma University, 3-39-15 Showa-machi, 371-8512, Maebashi, Japan;

关键词: Hyponatremia;    Aseptic meningitis;    SIADH;    Vasopressin;   

DOI  :  10.1186/s13256-021-02956-6

来源: Springer

【 摘 要 】

BackgroundSyndrome of inappropriate antidiuretic hormone secretion can be caused by arginine-vasopressin-producing tumors or enhanced arginine vasopressin secretion from the posterior pituitary gland due to central nervous system disorders and intrathoracic diseases.Case presentationA 53-year-old Asian man was hospitalized with complaints of tremor and hiccups. Laboratory examination revealed findings suggestive of hypotonic hyponatremia due to syndrome of inappropriate antidiuretic hormone secretion. The patient did not complain of headache or photophobia, and showed no signs of meningeal irritation. Positron emission tomography–computed tomography revealed 18F-fluoro-deoxy-glucose accumulation along the cervical spinal cord, based on which the patient was diagnosed as having aseptic meningitis. The hyponatremia was treated successfully by fluid restriction, and optimum plasma sodium concentration was maintained by tolvaptan administration.ConclusionsThis case underscores the need to consider the possibility of mild meningitis as the cause of syndrome of inappropriate antidiuretic hormone secretion in patients without other identifiable cause.

【 授权许可】

CC BY