ECE2019 Guided Posters Anterior and Posterior Pituitary (12 abstracts)
Copeptin levels in SIADH – a marker of malignant disease?
Bettina Winzeler 1 , Michelle Steinmetz 1 , Julie Refardt 1 , Nicole Cesana-Nigro 2 , Milica Popovic 1 , Wiebke Fenske 3 & Mirjam Christ-Crain 1
1University Hospital of Basel, Basel, Switzerland; 2Bürgerspital Solothurn, Solothurn, Switzerland; 3University of Leipzig, Leipzig, Germany.
Context: Hyponatremia due to the syndrome of inappropriate antidiuretic hormone secretion (SIADH) is a very common condition in hospitalized patients. It is crucial to establish the cause of SIADH especially in order to exclude or detect an underlying malignancy. As SIADH can be caused by paraneoplastically produced arginine vasopressin (AVP), we hypothesized that its stable surrogate marker copeptin may be used as a diagnostic tool.
Methods: We analyzed data from 146 patients with SIADH from two prospective observational studies, conducted in Switzerland and Germany, who were included while presenting at the emergency department. Patients underwent a standardized diagnostic assessment at admission including the measurement of copeptin levels.
Results: 39 patients (median age: 63 years, 51% female) were diagnosed with cancer-related and 107 (median age: 73 years, 68% female) with non-malignant SIADH. Serum sodium levels were higher in cancer-related versus non-malignant SIADH: median (IQR) 124 mmol/l (120; 127) versus 120 mmol/l (117; 123) (P < 0.001). Median (IQR) copeptin levels of patients with cancer-related SIADH were 11.1 pmol/l (5.2; 37.1) and 10.5 pmol/l (5.2; 25.2) with non-malignant SIADH (P=0.21). Among different cancer entities, patients suffering from small cell lung cancer showed the highest copeptin values, but overall no significant difference in copeptin levels between cancer types was observed (P=0.47).
Conclusion: We found no difference in copeptin levels between cancer-related and non-malignant SIADH. Copeptin is not suitable as diagnostic tool to exclude or detect an underlying malignancy in SIADH.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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