Syndrome of inappropriate secretion of antidiuretic hormone associated with angiotensin-converting enzyme inhibitor administration

Pediatric Cardiology
Tomoaki MurakamiKoichiro Niwa


Angiotensin-converting enzyme inhibitors (ACEI's) are an important medication in the treatment of congestive heart failure. However, ACEIs may cause harmful side effects, such as the syndrome of inappropriate secretion of antidiuretic hormone (SIADH), which is a rare but important side effect. We describe here a case of SIADH associated with ACEI administration in a 6-year-old boy with restrictive cardiomyopathy. After recovery from acute exacerbation of congestive heart failure by tolvaptan administration, an ACEI (cilazapril) was started to decrease the production of angiotensin II, which upregulates serum antidiuretic hormone secretion. The patient's heart failure symptoms worsened, including accumulation of right pleural effusion and ascites, after the initiation of ACEI administration. Cessation of ACEI administration dramatically improved his symptoms. Because it is difficult to distinguish SIADH associated with ACEI from worsening congestive heart failure, the possibility of fluid retention due to ACEI administration should always be considered when this agent is administered to patients with heart failure.


Jul 23, 1998·Physiological Reviews·J T Fitzsimons
Feb 17, 2000·The Annals of Pharmacotherapy·Z H ShaikhL A Llerena
Nov 16, 2006·The New England Journal of Medicine·Robert W SchrierSALT Investigators


Feb 21, 2016·European Journal of Pediatrics·Dietmar Schranz, Norbert F Voelkel
Jun 26, 2017·General Thoracic and Cardiovascular Surgery·Yuzo KatayamaYoshinori Watanabe
Mar 8, 2019·Journal of the Renin-angiotensin-aldosterone System : JRAAS·Takashin NakayamaSatoru Komatsumoto
Feb 24, 2017·American Journal of Physiology. Renal Physiology·Yu LinWeidong Wang

Related Concepts

Related Feeds


Cardiomyopathy is a disease of the heart muscle, that can lead to muscular or electrical dysfunction of the heart. It is often an irreversible disease that is associated with a poor prognosis. There are different causes and classifications of cardiomyopathies. Here are the latest discoveries pertaining to this disease.

Related Papers

Chinese Journal of Traumatology = Zhonghua Chuang Shang Za Zhi
Jia-ning CaiJun Yi
The Consultant Pharmacist : the Journal of the American Society of Consultant Pharmacists
Monique K BryanOlga Hilas
© 2021 Meta ULC. All rights reserved