Syndrome of Inappropriate Secretion of Antidiuretie Hormone (SIADH) Associated with
Herpes Zoster Ophhtalmicus

J Korean Neurol Assoc > Volume 14(1); 1996 > Article

Journal of the Korean Neurological Association 1996;14(1): 298-301.

부적합 항이뇨 홀몬 분비증을 동반한 Herpes Zoster Ophthalmicus

한문구, 이종걸, 한현성, 이광훈, 한설회, 이상수

충북대학교 의과대학 신경과학교실

Syndrome of Inappropriate Secretion of Antidiuretie Hormone (SIADH) Associated with Herpes Zoster Ophhtalmicus

Moon Ku Han, M.D., Jong Geol Lee, M.D., Hyun Jeong Han, M.D., Kwang Hoon Lee, M.D., Seol Heui Han, M.D., Sang Soo Lee, M.D.

Department of Neurology, College of Medicine, Chungbuk National University

Abstract

A case of syndrome of inappropriate secretion of antidiuretic hormome (SIADH) associated with herpes zoster ophthalmicus is reported. A 77-year-old man was admitted for treatment of left facial pain and vesicular lesions during 7 days. On admission, physical examination revealed vesicular eruptions on the left face and on neurologic examination, he revealed an alert, well-oriented mentality. Neither sensory disturbance nor nuchal rigidity was noted. Further investigation revealed hyponatremia 115mEq/L, low serum osmolality, high urine osmolarity, high urinary sodium secretion, normal renal function, normal adrenal and thyroid function. Cerebrospinal examination revealed a pleocytosis, mild protein elevation, normal glucose. No malignant cells were present and microorganism examinations were negative. Only water restriciton was started. But he revealed confusional mentality and aggravation of hyponatremia(110m2q/L). Intravenous hypertonic saline also was started, and the patient's sensorium was improved in accordance with the increase in serum sodium concentration. In the absence of other recognized causes we suggest that the two conditions(SIADH and Herpes Zoster Infection) may have related and speculate on possible mechanisms. In this report, we postulate that the hyponatremia was due to SIADH and that SIADH was caused by the infection of varicella-zoster virus(VZV) in central nervous system.