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Pneumologie 2013; 67(04): 219-222
DOI: 10.1055/s-0032-1326101
Case Report
© Georg Thieme Verlag KG Stuttgart · New York

Syndrome of Inadequate Antidiuretic Hormone Secretion in Pulmonary Tuberculosis – a Therapeutic Challenge

Case Report and Review of the LiteratureSyndrom der inadäquaten ADH-Sekretion bei Lungentuberkulose – eine therapeutische HerausforderungFallbericht und Literaturübersicht
H. Knoop
1   Department of Internal Medicine III – Respiratory and Critical Care Medicine, Berufsgenossenschaftliches Universitaetsklinikum Bergmannsheil GmbH, Ruhr-University of Bochum
,
U. Knoop
1   Department of Internal Medicine III – Respiratory and Critical Care Medicine, Berufsgenossenschaftliches Universitaetsklinikum Bergmannsheil GmbH, Ruhr-University of Bochum
,
J. Behr
1   Department of Internal Medicine III – Respiratory and Critical Care Medicine, Berufsgenossenschaftliches Universitaetsklinikum Bergmannsheil GmbH, Ruhr-University of Bochum
,
C. M. Heyer
2   Institute of Diagnostic Radiology, Interventional Radiology and Nuclear Medicine, Berufsgenossenschaftliches Universitaetsklinikum Bergmannsheil GmbH, Ruhr-University of Bochum
,
S. Kuert
1   Department of Internal Medicine III – Respiratory and Critical Care Medicine, Berufsgenossenschaftliches Universitaetsklinikum Bergmannsheil GmbH, Ruhr-University of Bochum
,
D. Roggenland
2   Institute of Diagnostic Radiology, Interventional Radiology and Nuclear Medicine, Berufsgenossenschaftliches Universitaetsklinikum Bergmannsheil GmbH, Ruhr-University of Bochum
,
M. Suermann
1   Department of Internal Medicine III – Respiratory and Critical Care Medicine, Berufsgenossenschaftliches Universitaetsklinikum Bergmannsheil GmbH, Ruhr-University of Bochum
,
J. W. Dietrich
3   Department of Internal Medicine I – Internal Medicine, Diabetology and Endocrinology, Berufsgenossenschaftliches Universitaetsklinikum Bergmannsheil GmbH, Ruhr-University of Bochum
› Author Affiliations
Further Information

Publication History

received 16 December 2012

accepted after revision 28 December 2012

Publication Date:
18 February 2013 (online)

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Abstract

A forty-nine-year-old female patient with pulmonary tuberculosis developed syndrome of inadequate antidiuretic hormone secretion. Consequent restriction of fluid intake as a therapeutic measure was just as ineffective as a medication with tolvaptan which was performed later on. A probable explanation for the inefficacy of the aquaretic drug is an interaction of rifampicine and tolvaptan. This case report gives a short summary of SIADH in pulmonary TB and discusses possible reasons for the difficult antituberculotic treatment in this patient.

Zusammenfassung

Eine 49-jährige Patientin mit ansteckungsfähiger Lungentuberkulose entwickelte ein Syndrom der inadäquaten ADH-Sekretion. Eine konsequente Beschränkung der Flüssigkeitszufuhr als erster therapeutischer Schritt zeigte keinen Erfolg – ebenso wenig wie die als weiterer Ansatz durchgeführte Behandlung mit Tolvaptan. Eine mögliche Erklärung für die fehlende Wirksamkeit von Tolvaptan stellt eine Arzneimittelinteraktion zwischen dem oralen V2-Rezeptorantagonisten und Rifampicin dar. Dieser Fallbericht gibt eine kurze Übersicht über SIADH im Rahmen von Lungentuberkulosen und diskutiert mögliche Ursachen für die schwierige antituberkulotische Therapie bei dieser Patientin.

 

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