A Natural Fermented Food as a Possible Cause of Syndrome of Inappropriate Secretion of Antidiuretic Hormone

Abstract

Syndrome of inappropriate secretion of antidiuretic hormone (SIADH) is caused by various drugs used in routine medical practice. Manda Koso (MK) is a fermented food product that contains many natural materials. Since MK is a natural food, it is considered to have no significant adverse effects. However, here we report a case of SIADH suspected of being induced by MK. A 76-year-old woman presenting with headache and vomiting was admitted. Blood examination revealed severe hyponatremia, with a serum sodium level of 120 mEq/L. Based on the results of careful examination, the diagnosis was SIADH. She had no history of central nervous system disorder or lung disease, and therefore drug-induced SIADH was considered. MK was a suspected product. One month after stopping taking MK, her symptoms disappeared, and serum sodium level, urinary sodium excretion, plasma and urinary osmolality, and plasma ADH level had completely normalized. Clinicians should be noted that a natural fermented food product can induce SIADH.




J Endocrinol Metab. 2015;5(6):340-341
doi: http://dx.doi.org/10.14740/jem320w