A severe H7N9 pneumonia with syndrome of inappropriate antidiuresis and vitamin D deficiency()

OBJECTIVE: Some H7N9 patients presented with hyponatremia. But whether SIAD could be the etiology of hyponatremia in H7N9 pneumonia is still not known. DESIGN, SETTING, AND PARTICIPANTS: A H7N9 patient was enrolled. Clinical sign were evaluated. Effective osmolality, urinary osmolality, urinary sodium, thyroid function, adrenal function, 25(OH) Vitamin D and cellular immune function were measured. RESULTS: (1) The results showed low serum osmolality, inappropriately elevated urine osmolality, elevated urine sodium concentration, low serum uric acid concentration, relatively normal serum creatinine concentration, normal acid-base and potassium balance, normal adrenal and thyroid function in our patient. (2) Our patient showed vitamin D deficiency and decline of cellular immune function. CONCLUSIONS: Some H7N9 pneumonia could cause SIAD. Early detection and appropriate treatment of SIAD in H7N9 pneumonia might be important. Our patient showed vitamin D deficiency and decline of cellular immune function.