.

3 Ectopic Production of Anti Diuretic Hormone

The ectopic production is also called by the syndrome of inappropriate
hormone secretion or in this case the syndrome of inappropriate antidiuretic hormone
secretion (SIADH) one of the cause of SIADH is the tumor. This syndrome is defined
by the hyponatremia and hypo-osmolality caused by the inappropriate and continued
secretion or action of Anti Diuretic Hormone (ADH) with normal or increased plasma
volume, which results in impaired water secretion1. In the simple way the ectopic
production of ADH is a condition in which the body make too much ADH and makes
the body to retain too much water.
The etiology of the syndrome of ectopic production from ADH can be divided
into four categories: nervous system and disorders, neoplasia, pulmonary diseases and
drug induced. In this case for the neoplastic disorders the etiology are: lung carcinoma
and mesothelioma, carcinoma of duodenum, pancreas and colon, adrenocortical
carcinoma, carcinomas of cervix, ureter/bladder, and prostate, and ovarian tumors,
and the other are brain tumors, carcinoid tumors, Ewing sarcoma, leukemia,
lymphoma, nasopharyngeal carcinoma, neuroblastoma (olfactory), and thymoma. 1
Overall tumor are the common cause of the ectopic production.2
The risk factors of the ectopic production caused by tumor are the increasing
age (>30), men appear to be more likely develop mild or moderate, but not severe
hyponatremia and low body weight.1
This kind of syndrome is a rare complication in neuroendocrine tumors
especially for the ectopic production of ADH, the most commonly observed are the
ectopic secretion of corticotrophin-releasing hormone (CRH) and
adrenocorticotrophic hormone (ACTH).3 One of the symptom of the ectopic
production of ADH is hyponatremia in which this symptom occurred in 15-22%
hospitalized patient, with 1-7% patient with moderate and severe hyponatremia.4

Daftar pustaka
1. Christie P T. Syndrome of Inappropriate Antidiuretic Hormone Secretion: Practice
Essentials, Background, Pathophysiology [Internet]. Emedicine.medscape.com.
2018 [cited 20 May 2018]. Available from:
https://emedicine.medscape.com/article/246650-overview
2. Gardner D, Shoback D. Greenspan's Basic & Clinical Endocrinology (8th Editon).
10th ed. Blacklick, USA: McGraw-Hill Professional Publishing; 2007.
3. G H. [Ectopic hormone secretion by neuroendocrine tumors]. - PubMed - NCBI
[Internet]. Ncbi.nlm.nih.gov. 2018 [cited 20 May 2018]. Available from:
https://www.ncbi.nlm.nih.gov/pubmed/22290319
4. Donal O’Donoghue. SIADH and Hyponatremia: foreword [Internet]. Clinical
Kidney Journal. 2009 [cited 20 May 2018]. Available from:
https://academic.oup.com/ckj/article/2/suppl_3/iii1/305679