Abstract：
We report the case of a 68-year-old man, who presented in emergency care with inarticulate speech. The patient was diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH) associated with pancreatic cancer. All diagnostic criteria for SIADH were met, and cancer of the pancreatic tail was identified by computed tomography. Standard treatment for SIADH includes water restriction, oral NaCl, continuous intravenous infusion of 3% NaCl, and intravenous infusion of furosemide. However, these treatments have varying effectiveness and are difficult for both patients and medical staff. Furthermore, unless treatment of the underlying disease is successful, continued hospitalization is needed and the patient\'s quality of life is significantly impaired. In this case, hyponatremia improved with this standard treatment, but ascites and edema developed. We treated the patient with tolvaptan due to decreased cardiac function, and symptoms improved rapidly. Although surgery and chemotherapy could not be performed for pancreatic cancer, the SIADH was treated for 7 months without relapse. In summary, a case of SIADH complicated by pancreatic cancer was difficult to control with standard treatment, but responded rapidly to tolvaptan, and outpatient treatment could be continued for a long period. Tolvaptan is useful for the treatment of SIADH associated with cancer.
摘要：
我们报道了一个68岁男子的病例,在急诊护理中以口齿不清的语言出现。患者被诊断为与胰腺癌相关的抗利尿激素不当综合征（SIADH）。符合SIADH的所有诊断标准，通过计算机断层扫描确定了胰尾癌。SIADH的标准治疗包括限水，口服NaCl，连续静脉输注3%NaCl,静脉输注呋塞米。然而,这些治疗方法的有效性各不相同，对患者和医务人员都很困难。此外，除非潜在疾病的治疗成功，需要继续住院治疗，患者的生活质量显著受损。在这种情况下,低钠血症通过这种标准治疗得到改善，但出现腹水和水肿。由于心功能下降，我们用托伐普坦治疗患者，症状迅速改善。尽管胰腺癌无法进行手术和化疗，SIADH治疗7个月无复发.总之,一例SIADH并发胰腺癌的病例，标准治疗难以控制，但对托伐普坦反应迅速，门诊治疗可以持续很长时间。托伐普坦可用于治疗与癌症相关的SIADH。
