Clinical analysis of gouty arthritis combined with syndrome of inappropriate antidiuretic of secretion hormone

GAO Xiaojuan; ZHAN Xingtao; CHEN Renli

doi:10.3969/j.issn.1672-8521.2025.05.012

Abstract：Objective To explore the clinical characteristics of gouty arthritis(GA)combined with syndrome of inappropriate secretion of antidiuretic hormone(SIADH),so as to improve clinicians'diagnosis and treatment level of this combination,effectively reduce the incidence of missed and misdiagnosis,and thereby improve patient prognosis and quality of life.Methods Eighteen patients diagnosed with GA and SIADH at Ningde Hospital Affiliated to Ningde Normal University between January 2015 and September 2024 were selected.General clinical data,including gender,age,clinical symptoms,and laboratory findings,were summarized.The trend of serum sodium levels in all patients was analyzed.Results All 18 patients were male,aged 54 to 84 years(mean 66.6±8.6).SIADH occurred following an acute GA attack.The clinical features of GA patients with SIADH included tophi(100.0%,18/18),polyarthritis(83.3%,15/18),and elevated interleukin-6(IL-6)(100.0%,18/18).Comorbidities included hypertension(14 cases),diabetes(4 cases),hyperlipidemia(10 cases),and metabolic syndrome(5 cases).Among these patients,16 presented with anorexia,nausea,or vomiting,2 exhibited mental abnormalities,and 3 reported headaches.Further analysis revealed a negative correlation between serum sodium levels and both IL-6 and C-reactive protein(CRP)levels(r=-0.975 and-0.928,respectively;P<0.05),suggesting a close association between hyponatremia and the severity of the inflammatory response.Following anti-inflammatory therapy and sodium supplementation,serum sodium levels normalized and symptoms gradually improved.Conclusions SIADH is a complication of acute GA attacks.It can occur in patients with severe gout presenting with tophi,polyarticular involvement,and significantly elevated IL-6 and CRP.Hyponatremia may also serve as an indicator of inflammatory arthritis,particularly GA.SIADH can be resolved with anti-inflammatory treatment.