{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T20:47:59Z","timestamp":1791406079297,"version":"4.3.3"},"reference-count":36,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2016,7,12]],"date-time":"2016-07-12T00:00:00Z","timestamp":1468281600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2016,12]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The syndrome of inappropriate antidiuresis (<jats:styled-content style=\"fixed-case\">SIAD<\/jats:styled-content>) is the commonest cause of hyponatraemia. Data on <jats:styled-content style=\"fixed-case\">SIAD<\/jats:styled-content> are mainly derived from retrospective studies, often with poor ascertainment of the minimum criteria for the correct diagnosis. Reliable data on the incidence of adrenal failure in <jats:styled-content style=\"fixed-case\">SIAD<\/jats:styled-content> are therefore unavailable. The aim of the study was to describe the aetiology of <jats:styled-content style=\"fixed-case\">SIAD<\/jats:styled-content> and in particular to define the prevalence of undiagnosed adrenal insufficiency.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Prospective, single centre, noninterventional, observational study of patients admitted to Beaumont Hospital with euvolaemic hyponatraemia (plasma sodium\u00a0\u2264\u00a0130\u00a0mmol\/l) between January 1st and October 1st 2015.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>A total of 1323 admissions with hyponatraemia were prospectively evaluated; 576 had euvolaemic hyponatraemia, with 573 (43\u00b74%) initially classified as <jats:styled-content style=\"fixed-case\">SIAD<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>(i) Aetiology of <jats:styled-content style=\"fixed-case\">SIAD<\/jats:styled-content>, defined by diagnostic criteria; (ii) Incidence of adrenal insufficiency.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Central nervous system diseases were the commonest cause of <jats:styled-content style=\"fixed-case\">SIAD<\/jats:styled-content> (<jats:italic>n\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>148, 26%) followed by pulmonary diseases (<jats:italic>n\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>111, 19%), malignancy (<jats:italic>n\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>105, 18%) and drugs (<jats:italic>n\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>47, 8%). A total of 22 patients (3\u00b78%), initially diagnosed as <jats:styled-content style=\"fixed-case\">SIAD<\/jats:styled-content>, were reclassified as secondary adrenal insufficiency on the basis of cortisol measurements and clinical presentation; 9\/22 cases had undiagnosed hypopituitarism; 13\/22 patients had secondary adrenal insufficiency due to exogenous steroid administration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In a large, prospective and well\u2010defined cohort of euvolaemic hyponatraemia, undiagnosed secondary adrenal insufficiency co\u2010occurred in 3\u00b78% of cases initially diagnosed as <jats:styled-content style=\"fixed-case\">SIAD<\/jats:styled-content>. Undiagnosed pituitary disease was responsible for 1\u00b75% of cases presenting as euvolaemic hyponatraemia.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.13128","type":"journal-article","created":{"date-parts":[[2016,6,6]],"date-time":"2016-06-06T15:08:51Z","timestamp":1465225731000},"page":"836-844","source":"Crossref","is-referenced-by-count":59,"title":["The contribution of undiagnosed adrenal insufficiency to euvolaemic hyponatraemia: results of a large prospective single\u2010centre study"],"prefix":"10.1111","volume":"85","author":[{"given":"Mart\u00edn","family":"Cuesta","sequence":"first","affiliation":[{"name":"Academic Department of Endocrinology Beaumont Hospital\/RCSI Medical School Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aoife","family":"Garrahy","sequence":"additional","affiliation":[{"name":"Academic Department of Endocrinology Beaumont Hospital\/RCSI Medical School Dublin 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