The prevalence of the syndrome of inappropriate antidiuretic hormone secretion (SIADH) in brucellosis patients: Systematic review and meta-analysis

BACKGROUND: Hyponatremia is a prevalent electrolyte abnormality amongst hospitalized patients. The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is a common cause of hyponatremia. Minimal literature described an association between SIADH and brucellosis. This paper aimed to systematically review the literature to synthesize the prevalence of SIADH in brucellosis patients. METHODS: We comprehensively searched PubMed, EMBASE, and Google scholar for observational studies examining the prevalence of SIADH in brucellosis patients. There were no age, language, or date limitations. We used a prevalence meta-analysis using the random-effects model with double arcsine and back transformation. I squared (I2) was used to determine heterogeneity. The MetaXl software was used for statistical analysis. RESULTS: Three observational studies met our inclusion criteria. The reported prevalence of SIADH in the constituent studies ranged from 3 to 56%. The quantitative synthesis, encompassing 306 patients’ data, revealed a pooled SIADH prevalence of 20% (95% CI 0.00–52%, I(2) 96%). The quality assessment revealed a moderate quality of included studies. The results were heterogeneous, as depicted by a high I(2). DISCUSSION AND CONCLUSION: The results from this review revealed a relatively high prevalence of SIADH of 20% in patients with brucellosis. Thus, hyponatremia in patients with chronic fever should prompt SIADH and brucellosis workup, particularly in endemic brucellosis areas. Likewise, patients with brucellosis merit hyponatremia screening. More extensive studies are needed to ascertain the exact prevalence of hyponatremia and SIADH in this patient cohort and their impact on the diagnosis and the overall prognosis.