ArticleInternal medicine (Tokyo, Japan)2026
Refractory SIAD Triggered by Herpes Zoster Ophthalmicus: Impact of Postherpetic Neuralgia on Hyponatremia Duration and the Role of Tolvaptan.
Article in Internal medicine (Tokyo, Japan), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
An 86-year-old man developed syndrome of inappropriate antidiuresis (SIAD) following herpes zoster ophthalmicus (HZO). The patient presented with symptomatic hyponatremia and impaired consciousness. Hypertonic and isotonic saline infusions improved both parameters; however, oral sodium supplementation and fluid restriction alone failed to maintain normonatremia. Tolvaptan was added, resulting in temporary correction of sodium levels; however, SIAD relapsed after discontinuation. Ultimately, SIAD resolved with improvement in neuropathic pain. This case highlights a therapeutic strategy for symptomatic hyponatremia and the appropriate use of tolvaptan in refractory SIAD, and provides a review of HZO-induced SIAD, an uncommon but noteworthy clinical entity.
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