{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T18:10:49Z","timestamp":1788891049686,"version":"build-2803163510"},"reference-count":169,"publisher":"Bioscientifica","issue":"9","license":[{"start":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["journals.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Severe or symptomatic hyponatremia during immune checkpoint inhibitor (ICI) therapy may reflect syndrome of inappropriate antidiuresis (SIADH), endocrine immune-related adverse events (irAEs), cancer-related factors, or mixed mechanisms. We mapped the evidence and reclassified diagnostically extractable cases to distinguish SIADH-like phenotypes from endocrine irAEs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed, Embase, Web of Science Core Collection, Scopus, and the Cochrane Library were searched through May 24, 2026. Reports were assigned to A1 case-level, A2 population-level, or A3 diagnostic-framework layers. A1 summaries used patient\/case denominators after a report-versus-patient audit. Diagnostic categories were reviewer-derived. Reporting completeness was described using six prespecified domains. We performed source-label and full-length-only sensitivity analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All 194 reports sought for retrieval were assessed, and 146 were included: 127 A1 reports describing 144 patients\/cases, 16 A2 reports, and 3 A3 reports. Strict classification identified 127\/144 (88.2%) confirmed\/probable adrenal-axis irAEs, 1\/144 (0.7%) confirmed\/probable SIADH, 3\/144 (2.1%) SIADH-like phenotypes with incomplete endocrine exclusion, 2\/144 (1.4%) thyroid-related cases, and 11\/144 (7.6%) mixed, confounded, or non-endocrine mechanisms. Ten patients\/cases carried an explicit source-level SIADH label; strict review classified six as adrenal-axis irAEs, one as SIADH, and three as SIADH-like with incomplete endocrine exclusion. After exclusion of 81 abstract\/database-only A1 reports, 46 full-length reports described 59 patients: 52 adrenal-axis irAEs, 1 SIADH, and 6 mixed\/confounded or non-endocrine cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Published classifiable A1 cases were dominated by adrenal-axis irAEs. Strictly supported SIADH occurred but was rare in this selected evidence base, and the direction of findings persisted in the full-length-only analysis. These proportions are not incidence estimates. The proposed algorithm supports diagnostic sequencing and transparent reporting; it is not a stand-alone practice guideline.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1530\/ec-26-0417","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T11:59:01Z","timestamp":1786708741000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-10","source":"Crossref","is-referenced-by-count":0,"title":["Immune checkpoint inhibitor-associated severe hyponatremia: evidence mapping of SIADH-like phenotypes and endocrine immune-related adverse events"],"prefix":"10.1530","volume":"15","author":[{"given":"Fangfei","family":"Guo","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, Gansu Provincial Hospital 1 , ,","place":["Lanzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4185-0108","authenticated-orcid":true,"given":"Songchen","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Gansu Provincial Hospital 2 , ,","place":["Lanzhou, China"]},{"name":"Jinan University 3 , ,","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhihui","family":"Xue","sequence":"additional","affiliation":[{"name":"Sunan County People\u2019s Hospital 4 , ,","place":["Zhangye, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenlong","family":"Chen","sequence":"additional","affiliation":[{"name":"Gansu University of Chinese Medicine 5 , ,","place":["Lanzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunjiu","family":"Gou","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Gansu Provincial Hospital 2 , ,","place":["Lanzhou, China"]},{"name":"Jinan University 3 , ,","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","published-online":{"date-parts":[[2026,8,14]]},"reference":[{"key":"2026090813564753300_bib1","doi-asserted-by":"crossref","first-page":"4073","DOI":"10.1200\/JCO.21.01440","article-title":"Management of immune-related adverse events in patients treated with immune checkpoint inhibitor therapy: ASCO guideline update","volume":"39","author":"Schneider","year":"2021","journal-title":"J Clin Oncol"},{"key":"2026090813564753300_bib2","doi-asserted-by":"crossref","DOI":"10.1136\/jitc-2021-002435","article-title":"Society for immunotherapy of cancer (SITC) clinical practice guideline on immune checkpoint inhibitor-related adverse events","volume":"9","author":"Brahmer","year":"2021","journal-title":"J Immunother Cancer"},{"key":"2026090813564753300_bib3","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1186\/s40425-017-0300-z","article-title":"Managing toxicities associated with immune checkpoint inhibitors: consensus recommendations from the society for immunotherapy of cancer (SITC) Toxicity Management Working Group","volume":"5","author":"Puzanov","year":"2017","journal-title":"J Immunother Cancer"},{"key":"2026090813564753300_bib4","doi-asserted-by":"crossref","first-page":"iv119","DOI":"10.1093\/annonc\/mdx225","article-title":"Management of toxicities from immunotherapy: ESMO clinical practice guidelines for diagnosis, treatment and follow-up","volume":"28","author":"Haanen","year":"2017","journal-title":"Ann Oncol"},{"key":"2026090813564753300_bib5","doi-asserted-by":"crossref","first-page":"G1","DOI":"10.1530\/EJE-22-0689","article-title":"Endocrine-related adverse conditions in patients receiving immune checkpoint inhibition: an ESE clinical practice guideline","volume":"187","author":"Husebye","year":"2022","journal-title":"Eur J Endocrinol"},{"key":"2026090813564753300_bib6","doi-asserted-by":"crossref","first-page":"R207","DOI":"10.1530\/EC-20-0342","article-title":"Management of endocrine immune-related adverse events of immune checkpoint inhibitors: an updated review","volume":"9","author":"Stelmachowska-Bana\u015b","year":"2020","journal-title":"Endocr Connect"},{"key":"2026090813564753300_bib7","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1038\/s41574-021-00484-3","article-title":"Endocrine toxicities of immune checkpoint inhibitors","volume":"17","author":"Wright","year":"2021","journal-title":"Nat Rev Endocrinol"},{"key":"2026090813564753300_bib8","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1038\/nrendo.2016.205","article-title":"Cancer immunotherapy - 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