The syndrome of inappropriate secretion of antidiuretic hormone (SIADH) — Treatment with lithium

Two patients with SIADH after brain trauma are described. Features of SIADH are inappropriate antidiuresis and excessive natriuresis with negative sodium balance resulting in hyponatremia and plasma hypoosmolality which may lead to cerebral dysfunction. Oral lithium carbonate was beneficial bral dysfunction. Oral lithium carbonate was beneficial in both patients. With plasma levels of lithium around 1 mmol/l a temporary impairment of renal concentrating ability and antinatriuresis with normalization of plasma sodium and plasma osmolality was observed. The SIADH subsided about 4 months after the original trauma, long after gross neurological symptoms had resolved.