Syndrome of inappropriate secretion of antidiuretic hormone
ICD-10 E22.2 is a billable code used to indicate a diagnosis of syndrome of inappropriate secretion of antidiuretic hormone.
The Syndrome of Inappropriate Secretion of Antidiuretic Hormone (SIADH) is a condition characterized by excessive release of antidiuretic hormone (ADH) from the posterior pituitary gland, leading to water retention, hyponatremia, and dilutional effects on serum sodium levels. This syndrome can be triggered by various factors, including central nervous system disorders (such as head trauma, infections, or tumors), malignancies (especially small cell lung cancer), pulmonary disorders (like pneumonia or tuberculosis), and certain medications. The pathophysiology involves the inappropriate regulation of water balance, resulting in the kidneys reabsorbing excess water, which dilutes serum sodium and can lead to neurological symptoms such as confusion, seizures, and coma in severe cases. Diagnosis typically involves clinical evaluation, serum and urine osmolality measurements, and exclusion of other causes of hyponatremia. Treatment focuses on addressing the underlying cause, fluid restriction, and in some cases, the use of medications such as vasopressin receptor antagonists.
Detailed patient history, lab results, and treatment plans must be documented to support the diagnosis.
Patients presenting with hyponatremia, confusion, or seizures requiring evaluation of ADH levels.
Endocrinologists must ensure that all potential causes of SIADH are explored and documented.
Comprehensive renal function tests and fluid balance assessments are essential.
Patients with chronic kidney disease presenting with electrolyte imbalances.
Nephrologists should document the impact of renal function on fluid and electrolyte management.
Used to evaluate electrolyte levels in patients suspected of SIADH.
Document all lab results and clinical findings.
Endocrinologists and nephrologists should ensure comprehensive lab evaluations.
Common causes include central nervous system disorders, malignancies, pulmonary diseases, and certain medications. Each cause may require different management strategies.
