Syndrome of Inappropriate Antidiuretic Hormone Secretion in ChildrenSíndrome de secreción inadecuada de la hormona antidiurética (SIADH)

Syndrome of Inappropriate Antidiuretic Hormone Secretion in Children

What is syndrome of inappropriate antidiuretic hormone secretion (SIADH)?

SIADH is when the body makes too much antidiuretic hormone (ADH). This is a hormone that normally helps the kidneys conserve the correct amount of water in the body. SIADH causes the body to retain water. This lowers the level of sodium in the blood. SIADH is rare. It most often happens to children who are in the hospital.

What causes SIADH?

SIADH tends to occur in people with heart failure or with a brain injury that affects the hypothalamus. The hypothalamus is the part of the brain that works with the pituitary gland to make hormones. Other causes may include:

  • Inflammation of the membranes that cover the brain and spinal cord (meningitis)
  • Inflammation of the brain (encephalitis )
  • Brain tumor
  • Psychosis
  • Lung disease
  • Head injury
  • Guillain-Barré syndrome
  • Certain medicines
  • Damage to the hypothalamus or pituitary gland during surgery
  • Low amounts of thyroid or parathyroid hormones
  • HIV
  • Hereditary causes

What are the symptoms of SIADH?

Symptoms can occur a bit differently in each child. In severe cases, symptoms can include:

  • Nausea or vomiting
  • Cramps or tremors
  • Depressed mood
  • Irritability
  • Memory problems
  • Personality changes, such as anger and confusion
  • Hallucinations
  • Seizures
  • Coma

The symptoms of SIADH can be like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.

How is SIADH diagnosed?

The healthcare provider will ask about your child’s symptoms and health history. He or she may also ask about your family’s health history. He or she will give your child a physical exam. Your child may also have blood and urine tests. These tests are done to check:

  • Sodium levels in the body
  • Potassium levels in the body
  • Amount of substances dissolved in blood and urine (osmolality)

How is SIADH treated?

The most common treatment for SIADH is limiting how much fluid and water your child has. If the condition is ongoing (chronic), your child may need to limit fluids for life. Treatment may also include:

  • Use of medicine called vasopressin that blocks the action of ADH
  • Surgery to remove a tumor that is making ADH
  • Other medicines to help manage body fluid volume

What are possible complications of SIADH?

Complications of SIADH depend on how low blood sodium levels are. Possible mild complications include:

  • Headaches
  • Depression
  • Memory problems
  • Muscle cramps
  • Tremors

Possible severe complications include

  • Hallucinations
  • Seizures
  • Respiratory failure
  • Coma
  • Death

Living with SIADH

A child with chronic SIADH may need to permanently limit how much fluid he or she has. Work with your child's healthcare providers to create an ongoing plan to manage your child’s condition.

When should I call my child's healthcare provider?

Get medical attention right away if your child has symptoms of SIADH.

Call the healthcare provider if your child has chronic SIADH and any of the below occur:

  • You have trouble restricting your child's fluid intake
  • Your child has new symptoms        

Key points about SIADH

  • SIADH is when the body makes too much antidiuretic hormone (ADH). This is a hormone that normally helps the kidneys conserve the correct amount of water in the body.
  • SIADH causes the body to retain water. This lowers the level of sodium in the blood. SIADH is rare.
  • SIADH tends to occur in people with heart failure or with a brain injury that affects the hypothalamus.
  • In severe cases, symptoms can include nausea or vomiting, cramps or tremors, irritability, and memory problems
  • The most common treatment for SIADH is limiting how much fluid and water your child has. A child with chronic SIADH may need to permanently limit fluids.
  • Treatment may also include medicines or surgery.

Next steps

Tips to help you get the most from a visit to your child’s health care provider:
  • Before your visit, write down questions you want answered.
  • At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you for your child.
  • If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.
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