Copeptin is Not Useful As a Marker of Malignant Disease in the Syndrome of Inappropriate Antidiuresis

Overview

Journal Endocr Connect

Specialty Endocrinology

Date 2019 Dec 4

PMID 31794422

Citations 5

Authors

Bettina Winzeler

Michelle Steinmetz

Julie Refardt

Nicole Cesana-Nigro

Milica Popovic

Wiebke Fenske

Mirjam Christ-Crain

Affiliations

Soon will be listed here.

Abstract

Objective: The syndrome of inappropriate antidiuresis (SIAD) is a common condition in hospitalized patients. It is crucial to establish the cause of SIAD, especially in order to exclude underlying malignancy. As malignant SIAD may be due to a paraneoplastic synthesis of arginine vasopressin, we hypothesized that its stable surrogate marker copeptin can be used as a diagnostic tool to differentiate between malignant and non-malignant SIAD.

Methods: Prospective observational study. We analyzed data from 146 SIAD patients of two different cohorts from Switzerland and Germany. Patients were included while presenting at the emergency department and underwent a standardized diagnostic assessment including the measurement of copeptin levels.

Results: Thirty-nine patients (median age: 63 years, 51% female) were diagnosed with cancer-related SIAD and 107 (median age: 73 years, 68% female) with non-malignant SIAD. Serum sodium levels were higher in cancer-related versus non-malignant SIAD: 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 SIAD were 11.1 pmol/l (5.2; 37.1) and 10.5 pmol/l (5.2; 25.2) with non-malignant SIAD (P = 0.38). 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 = 0.46).

Conclusions: Copeptin levels are similar in cancer-related and non-malignant SIAD. Therefore, Copeptin does not seem to be suitable as a marker of malignant disease in SIAD.

Citing Articles

Case report: Secondary failure to tolvaptan in a patient with SCLC and paraneoplastic SIADH.

Menzi S, Jaramillo S, Pfister S, Schefer H, Jehle A Front Endocrinol (Lausanne). 2024; 15:1382066.

PMID: 38803472 PMC: 11128599. DOI: 10.3389/fendo.2024.1382066.

Syndrome of Inappropriate Antidiuresis: From Pathophysiology to Management.

Warren A, Grossmann M, Christ-Crain M, Russell N Endocr Rev. 2023; 44(5):819-861.

PMID: 36974717 PMC: 10502587. DOI: 10.1210/endrev/bnad010.

Pulmonary Embolism Risk Assessment Using Blood Copeptin Concentration and Pulmonary Arteries Thrombotic Burden Evaluated by Computer Tomography.

Haba M, Tudorancea I, Miftode R, Popa I, Mitu O, Mihai C J Pers Med. 2022; 12(12).

PMID: 36556304 PMC: 9786201. DOI: 10.3390/jpm12122084.

Approach to the Patient: "Utility of the Copeptin Assay".

Christ-Crain M, Refardt J, Winzeler B J Clin Endocrinol Metab. 2022; 107(6):1727-1738.

PMID: 35137148 PMC: 9113794. DOI: 10.1210/clinem/dgac070.

A narrative review of progress in diagnosis and treatment of small cell lung cancer patients with hyponatremia.

Wu R, Li C, Wang Z, Fan H, Song Y, Liu H Transl Lung Cancer Res. 2021; 9(6):2469-2478.

PMID: 33489807 PMC: 7815354. DOI: 10.21037/tlcr-20-1147.

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