ADH分泌異常症を伴つた陰部電撃性壊疽

NECROTIZING FASCIITIS OF GENITALIA WITH SYNDROME OF INAPPROPRIATE SECRETION OF ANTIDIURETIC HORMONE: REPORT OF A CASE

　ADH分泌異常症を伴つた比較的稀な臨床経過をたどつた陰部電撃性壊疽の1例を報告した。74歳男性，会陰部の疼痛と腫脹，発熱で来院。尿道狭窄より生じた会陰部膿瘍と診断したが，その後に会陰部にガスの発生，壊死，脱落を認め陰部電撃性壊疽と判明した。同時に低Na血症を有しており，諸検査よりADH分泌異常症と診断された。治療により病状は一時軽快したが，発症1年後に続発したガス壊疽にて死亡した。

A rare case of a gangrene on the perineum and penis, associated with syndrome of inappropriate secretion of antidiureitic hormone (SIADH), is described. A 74-year-old male with diabetes mellitus had a 2-day history of painful induration on the perineum and high fever. The induration gra-dually became gangrenous and necrotic with crepitation after 10 days of hospitalization. Then, the diagnosis of Fournier's gangrene (necrotizing fasciitis of genitalia) was made. He also had suspected SIADH because of additional laboratory data, such as hyponatremia (110 mEq/L) without edema,