SIADH and Guillain-Barre Syndrome Associated with Pulmonary Tuberculosis

Yu, Mi Hyun; Chang, Jai Won; Yang, Won Seok; Kim, Soon Bae; Lee, Sang Koo; Park, Su Kil; Park, Jung Sik

Abstract

Hyponatremia is one of the most common electrolyte disturbances in nephrologic clinical setting. SIADH is one of the causes of hyponatremia and can be accompanied with various conditions such as malignancies, infections and nervous system diseases. Guillain-Barre syndrome is an acute inflammatory polyneuropathy. It is reported that SIADH can be accompanied with Guillain-Barre syndrome although the mechanism is unclear. Symptoms of Guillain- Barre syndrome such as general weakness, decreased consciousness, and seizure are similar to those of hyponatremia. Thus the diagnosis of Guillain-Barre syndrome can be delayed if they coexist. Because Guillain-Barre syndrome leads to severe respiratory failure in its disease course and mechanical ventilatory assistance is mandatory for such cases, early diagnosis and treatment is critical. Korea is still endemic area for tuberculosis and clinicians often experience pulmonary tuberculosis in practice. But pulmonary tuberculosis-associated SIADH and Guillain-Barre syndrome were not reported in Korea. So far, 2 cases of gastrointestinal infection-associated SIADH and Guillain-Barre syndrome were reported. Hence, authors report here the case of SIADH associated Guillain-Barre syndrome associated with pulmonary tuberculosis.