The key difference between SIADH and CSW is that syndrome of inappropriate antidiuretic hormone (SIADH) is a condition that results in too much water retaining and hyponatremia, while cerebral salt wasting (CSW) is a condition that results in hyponatremia and severe dehydration.
Hyponatremia is a state with a lower-than-normal sodium level in the bloodstream. It can result from certain medications, heart, kidney, and liver problems, SIADH, CSW, chronic, severe vomiting or diarrhea, drinking too much water, hormonal changes, and the use of the recreational drug Ecstasy. Therefore, SIADH and CSW are two different medical conditions that lead to hyponatremia.
CONTENTS
1. Overview and Key Difference
2. What is SIADH (Syndrome of Inappropriate Antidiuretic Hormone)
3. What is CSW (Cerebral Salt Wasting)
4. Similarities – SIADH and CSW
5. SIADH vs. CSW in Tabular Form
6. Summary – SIADH vs. CSW
What is SIADH?
SIADH occurs when the body makes too much antidiuretic hormone (ADH). This is due to the unsuppressed release of ADH from the pituitary gland or nonpituitary sources or its continued action on vasopressin receptors. SIADH ultimately leads to retaining too much water and hyponatremia in the body. It was first identified in two patients with lung cancer by William Schwartz and Frederic Bartter in 1967. The symptoms of SIADH may include muscle cramps or weakness, nausea, vomiting, headache, problems with balance, mental changes, such as confusion, memory problems or behavioural problems, seizures or coma, and a decrease in serum sodium concentration. Unsuppressed release of antidiuretic hormone (ADH) can be caused by other medical conditions like certain cancers, certain medications (heart, diabetes, or other medications), surgeries, lung diseases like pneumonia, hormone deficiencies, and mutation in a gene called vasopressin 2 (V2R) receptors in the kidneys.
Moreover, SAIDH can be diagnosed through physical examination, comprehensive metabolic panels (CMP), blood osmolality tests, urine osmolality tests, urine electrolytes tests (sodium and potassium), toxicology screening tests for certain medications, and genetic testing. Furthermore, treatment options for SAIDH may include managing underlying conditions like tumor removal, limiting fluid intake, giving salt solution intravenously, and medications to block the effects of ADH, such as tolvaptan and conivaptan.
What is CSW?
Cerebral salt wasting (CSW) is a condition that leads to hyponatremia and severe dehydration due to head injury. This disease was first described in 1950. CSW can be caused by neurological injury such as aneurysmal subarachnoid hemorrhage, after surgery for a pituitary tumor, acoustic neuroma, calvarial remodeling, glioma, infections such as tuberculosis, meningitis, metastatic carcinoma, and cranial trauma. The typical signs and symptoms of CSW may include lethargy, agitation, headache, changed consciousness, seizures, coma, and a decrease in serum sodium concentration.
Moreover, CSW can be diagnosed through physical examination, basic metabolic panel (BMP), urine studies, and neurological testing. CSW can be treated through intravenous administration of isotonic or hypertonic fluids to correct volume depletion, sodium replacement, and giving mineralocorticoid medication such as fludrocortisone to improve sodium levels.
What are the Similarities Between SIADH and CSW?
- SIADH and CSW are two different medical conditions that lead to
- Both these can be triggered by underlying medical conditions.
- These can be diagnosed through physical examinations, blood tests, and urine tests.
- They are mainly treated through intravenous sodium replacement.
What is the Difference Between SIADH and CSW?
SIADH is a condition that is due to the unsuppressed release of antidiuretic hormone (ADH) from the pituitary gland or nonpituitary sources that leads to retaining too much water and hyponatremia in the body, while CSW is a condition that is due to head injury which leads to hyponatremia and dehydration. Thus, this is the key difference between SIADH and CSW.
The infographic below presents the differences between SIADH and CSW in tabular form for side-by-side comparison.
Summary – SIADH vs CSW
Sodium is an important electrolyte that helps regulate the water that is in and around the cells. Hyponatremia is a medical condition that occurs due to low concentrations of sodium in the blood. In hyponatremia, sodium level is abnormally low. SIADH and CSW are two different medical conditions that lead to hyponatremia. SIADH is due to the unsuppressed release of antidiuretic hormone (ADH) from the pituitary gland or nonpituitary sources. On the other hand, CSW is due to a head injury. Both these conditions lead to hyponatremia. However, SIADH causes water retention, while CSW causes severe dehydration. So, this summarizes the difference between SIADH and CSW.
Reference:
1. “Syndrome of Inappropriate Antidiuretic Hormone Secretion.” Statpearls.
2. “Cerebral Salt Wasting.” An Overview | ScienceDirect Topics.
Image Courtesy:
1. “ADH Abnormalities” By Maen K. Househ – Own work (CC BY-SA 3.0) via Commons Wikimedia