Hyponatremia and anti-diuretic hormone in Legionnaires' disease

BMC Infectious Diseases
Philipp SchuetzProHOSP Study Group

Abstract

Medical textbooks often list Legionnaires' disease as a differential diagnosis of the syndrome of inappropriate secretion of anti-diuretic hormone (ADH) (SIADH), but evidence supporting this association is largely lacking. We tested the hypothesis whether hyponatremia in patients with Legionnaires' disease would be caused by increased CT-ProVasopressin. We measured CT-ProVasopressin and sodium levels in a prospective cohort of 873 pneumonia patients from a previous multicentre study with 27 patients having positive antigen tests for Legionella pneumophila. Patients with Legionnaires' disease more frequently had low sodium levels (Na < 130 mmol/L) (44.4% vs 8.2%, p < 0.01), but similar mean CT-ProVasopressin levels (pmol/l) (39.4 [±7] vs 51.2 [±2.7], p = 0.43) as compared to patients with pneumonia of other etiologies. In patients with Legionnaires' disease, CT-ProVasopressin levels showed a positive correlation with sodium (r = 0.42, p < 0.05). Independent of pneumonia etiology, CT-ProVasopressin correlated significantly with the pneumonia severity index (r = 0.56, p < 0.05), ICU admission (adjusted odds ratio per decile, 95% CI) (1.6, 1.2 - 2.0), and 30-day-mortality (1.8, 1.3 - 2.4). While Legionnaires' disease was associated...Continue Reading

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Citations

Mar 3, 2015·Journal of Thoracic Imaging·Marie-Helene LevesqueAmita Sharma
May 21, 2016·Respirology : Official Journal of the Asian Pacific Society of Respirology·Heather L IsenmanDavid R Murdoch
Dec 3, 2016·Internal Medicine·Akihiro RyugeShoichi Maruyama
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Aug 23, 2020·Critical Care Medicine·Jennifer A FronteraElizabeth Hammer
Jan 31, 2021·Journal of Nephrology·Ravindra Attur PrabhuChiranjay Mukhopadhyay
Nov 11, 2019·La Revue de médecine interne·S CattanE Lafont
Jun 8, 2021·BMC Infectious Diseases·Gabriella SerioLuigi Vimercati

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Methods Mentioned

BETA
X-ray
PCR
sandwich immunoassay

Clinical Trials Mentioned

NCT00350987

Software Mentioned

STATA

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