aetiology
Last reviewed 03/2023
About 30% of cases are idiopathic. Other common causes are head injury - 30% of cases - and pituitary tumours.
Familial - extremely uncommon:
- dominant inheritance
- associated with diabetes mellitus, optic atrophy, nerve deafness, atonia of bladder
Acquired:
- idiopathic - a third of cases show an autoimmune basis with circulating antibodies to hypothalamic neurones, not to circulating ADH
- head injury and neurosurgery
- neoplastic - pituitary tumour, craniopharyngioma, dysgerminoma, hypothalamic metastases - often in children
- infectious - meningitis, encephalitis
- granulomatous disease - sarcoidosis, histiocytosis
- vascular - aneurysm, sickle cell anaemia, Sheehan's syndrome
- drugs - ADH secretion is suppressed by naloxone, ethanol and phenytoin