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hyponatremia diagnosis and treatment

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https://www.readbyqxmd.com/read/29730273/differences-in-associations-of-antiepileptic-drugs-and-hospitalization-due-to-hyponatremia-a-population-based-case-control-study
#1
Henrik Falhammar, Jonatan D Lindh, Jan Calissendorff, Shermineh Farmand, Jakob Skov, David Nathanson, Buster Mannheimer
PURPOSE: Hyponatremia induced by antiepileptic drugs is common, but detailed evidence is lacking. This can be problematic for the treating neurologist confronted with a patient with severe hyponatremia in need of an alternative drug. The objective of this study was to examine the association between individual antiepileptic drugs and hospitalization due to hyponatremia. METHODS: This was a register-based case-control study of patients in the general Swedish population...
April 30, 2018: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/29685474/the-evaluation-and-management-of-rocky-mountain-spotted-fever-in-the-emergency-department-a-review-of-the-literature
#2
Michael Gottlieb, Brit Long, Alex Koyfman
BACKGROUND: Rocky Mountain spotted fever (RMSF) is potentially deadly and can present subtly with signs and symptoms overlapping with other clinical conditions. Delayed diagnosis can be fatal. OBJECTIVE: This review provides an evidence-based summary of the current data for the evaluation and management of RMSF in the emergency department. DISCUSSION: RMSF occurs through transmission of Rickettsia rickettsii by an infected tick. Exposure in the United States occurs most commonly from April to September, and high-risk locations include wooded, shrubby, or grassy areas...
April 20, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29684948/-successful-treatment-of-peritoneal-dissemination-recurrence-with-axitinib-in-papillary-renal-cell-carcinoma-a-case-report
#3
Junichi Mori, Yuki Nakayama, Tsuyoshi Hiragino, Hideyasu Matsuyama
We report a case of successful treatment of recurrence of peritoneal dissemination with axitinib. A 55-year-old man presented at our hospital with the chief complaint of remarkable abdominal fullness 18 months after right radical nephrectomy, which had been performed at another hospital for the treatment of renal cell carcinoma. The pathological diagnosis was papillary renal cell carcinoma type 1, pT3aN0M0. A large amount of ascites was detected by computed tomography, and recurrence of peritoneal dissemination was diagnosed (ascites cytology : class V)...
February 2018: Hinyokika Kiyo. Acta Urologica Japonica
https://www.readbyqxmd.com/read/29675281/coexistent-non-small-cell-carcinoma-and-small-cell-carcinoma-in-a-patient-presenting-with-hyponatremia
#4
Mitchell D Ross, Sreeja Biswas Roy, Pradnya D Patil, Jasmine L Huang, Nitika Thawani, Ralph Drosten, Tanmay S Panchabhai
Despite recent advances in screening methods, lung cancer remains the leading cause of cancer-related deaths worldwide. By the time lung cancer becomes symptomatic and patients seek treatment, it is often too advanced for curative measures. Low-dose computed tomography (CT) screening has been shown to reduce mortality in patients at high risk of lung cancer. We present a 66-year-old man with a 50-pack-year smoking history who had a right upper lobe (RUL) pulmonary nodule and left lower lobe (LLL) consolidation on a screening CT...
2018: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/29595672/a-case-report-of-a-man-on-peritoneal-dialysis-having-intractable-hyponatremia
#5
Xu-Jie Zhou, Ying Yang, Tao Su, Jie Dong
RATIONALE: Hyponatremia is one of the most common electrolyte disorders in patients on peritoneal dialysis (PD). It can be associated with severe consequences, higher morbidity and mortality. Therefore, hyponatremia should be assessed and monitored more carefully in these patients. PATIENT CONCERNS: A 55-year-old male PD patient progressively developed intractable hyponatremia was admitted to our hospital. DIAGNOSES: The observation that no significant salt was lost in kidney and PD drainage prompted us to seek the underlying reasons for malnutrition and chronic inflammation...
March 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29553924/porphyria-what-is-it-and-who-should-be-evaluated
#6
Yonatan Edel, Rivka Mamet
The porphyrias are a group of rare metabolic disorders, inherited or acquired, along the heme biosynthetic pathway, which could manifest with neurovisceral and/or cutaneous symptoms, depending on the defective enzyme. Neurovisceral porphyrias are characterized by acute attacks, in which excessive heme production is induced following exposure to a trigger. An acute attack usually presents with severe abdominal pain, vomiting, and tachycardia. Other symptoms which could appear include hypertension, hyponatremia, peripheral neuropathy, and mild mental symptoms...
April 19, 2018: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/29525234/syndrome-of-inappropriate-antidiuretic-hormone-secretion-in-a-mini-breed-puppy-associated-with-aspiration-pneumonia
#7
Rocío Martínez, Carlos Torrente
A 3-month-old intact male Prague ratter was presented to the emergency service for evaluation of progressive lethargy, weakness, coughing and labour breathing after an episode of resistance to oral deworming. The patient exhibited depression, increased respiratory effort and cyanosis at initial presentation. Results of first diagnostic work-up (complete blood cell count, biochemistry panel and thoracic x-rays) were all consistent with aspiration pneumonia. The puppy was initially treated with balanced isotonic crystalloids, broad spectrum antibiotics, nebulization with thoracic coupage and was transferred to an infant incubator with a sustained FiO2 of 40-50%...
December 2017: Topics in Companion Animal Medicine
https://www.readbyqxmd.com/read/29475919/thyrotoxicosis-and-adrenocortical-hormone-deficiency-during-immune-checkpoint-inhibitor-treatment-for-malignant-melanoma
#8
Hiroyuki Ariyasu, Hidefumi Inaba, Takayuki Ota, Hiroyuki Yamaoka, Yasushi Furukawa, Hiroshi Iwakura, Naotaka Doi, Yuki Yamamoto, Takashi Akamizu
BACKGROUND: Immune-checkpoint inhibitors (ICIs) are novel promising agents for the treatment of malignant tumors. However, critical endocrine immune-related adverse events (irAEs) by ICIs often occur. CASE REPORT: A 63-year-old woman with advanced malignant melanoma had received anti-PD-1 antibody (nivolumab, 2 mg/kg every 3 weeks) for 8 cycles (from day 0 to day 147). On day 168, nivolumab was switched to anti-CTLA-4 antibody (ipilimumab, 3mg/kg every 3 weeks)...
March 2018: In Vivo
https://www.readbyqxmd.com/read/29475597/-autoimmune-hypophysitis-associated-with-new-anti-cancer-immunotherapies
#9
REVIEW
Arnaud Jannin, Emilie Merlen, Christine Do Cao, Nicolas Penel
Recently developed immunotherapeutic agents, like anti-cytotoxic T lymphocyte antigen 4 antibody (CTLA4), anti-programmed cell death 1 (PD1) or anti-programmed cell death-ligand 1 (PDL1), have demonstrated substantial potential for the treatment of a variety of malignancies. Autoimmune side effects from these agents are diverse and can include multiple endocrinopathies like immunotherapy induced hypophysitis (IH). These toxicities appear to be more frequent in patients receiving anti-CTLA4 antibody compared to PD1/PDL1 agents...
March 2018: Bulletin du Cancer
https://www.readbyqxmd.com/read/29472987/adult-female-with-symptomatic-avpr2-related-nephrogenic-syndrome-of-inappropriate-antidiuresis-nsiad
#10
Jennifer Hague, Ruth Casey, Jonathan Bruty, Tom Legerton, Stephen Abbs, Susan Oddy, Andrew S Powlson, Mohamed Majeed, Mark Gurnell, Soo-Mi Park, Helen Simpson
Activating mutations in AVPR2 are associated with nephrogenic syndrome of inappropriate antidiuresis (NSIAD). NSIAD causes hyponatremia, decreased serum osmolality and clinical symptoms, which may present from birth or in infancy and include hypotonia, irritability, vomiting and/or seizures. Symptoms in later life are often less specific and include malaise, dizziness, confusion, tiredness and headache. NSIAD is a rare X-linked condition, which is associated with a variable phenotype in males, of whom some present in infancy but others do not become symptomatic until adulthood, or occasionally, never...
2018: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29465574/simultaneous-acute-marchiafava-bignami-disease-and-central-pontine-myelinolysis-a-case-report-of-a-challenging-diagnosis
#11
Chun-Yi Tsai, Po-Kai Huang, Poyin Huang
RATIONALE: Marchiafava-Bignami disease (MBD) is a rare disease characterized by demyelination of the corpus callosum. It is most commonly seen in patients with chronic alcoholism. The clinical diagnosis of MBD can be difficult due to its nonspecific manifestation. Central pontine myelinolysis (CPM) occurs mostly as a complication of severe and prolonged hyponatremia, especially when corrected too rapidly. However, CPM can be associated with chronic alcoholism and its clinical presentation can be heterogeneous...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29456852/xanthogranulomatous-pituitary-adenoma-a-case-report-and-literature-review
#12
Guihong Li, Chaochao Zhang, Yuxue Sun, Qingchun Mu, Haiyan Huang
Xanthogranuloma, also referred to as cholesterol granuloma or xanthogranulomatous reaction, is a granulomatous lesion that is infrequently found in the sellar and parasellar regions. Xanthogranulomatous pituitary adenoma is relatively rare and, thus, the etiology, diagnosis, management and prognosis of this condition remain incompletely understood. We herein report the case of a 56-year-old female patient who presented to our institution with intermittent headache, vomiting and distending pain in the bilateral orbital regions...
March 2018: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/29419955/-predictive-factors-of-gangrenous-post-appendectomy-intra-abdominal-abscess-a-case-control-study
#13
J Serradilla, A Bueno, C De la Torre, E Domínguez, A Sánchez, B Nava, M Álvarez, M López Santamaría, L Martínez
BACKGROUND: Acute appendicitis is the most frequent surgical urgency in children. Frequently, it can be complicated with an intraabdominal abscess that will require a longer and expensive treatment. Our aim is to know if it is possible to predict this complication before its beginning. MATERIAL AND METHODS: Retrospective case-control study with patients treated between 2011 and 2016, paired according to their own characteristics (age, sex and weight), clinical aspects (symptoms, time of their onset, physical examination) and type of appendicitis (gangrenous)...
February 1, 2018: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/29417373/practical-issues-for-the-management-of-hyponatremia-in-oncology
#14
Rossana Berardi, Andrea Antonuzzo, Livio Blasi, Roberta Buosi, Vito Lorusso, Maria Rita Migliorino, Vincenzo Montesarchio, Nicoletta Zilembo, Roberto Sabbatini, Alessandro Peri
Hyponatremia is common in cancer patients and has a negative impact on outcomes and survival. Both the diagnosis and treatment of hyponatremia are challenging. Easy-to-use, practical guidelines are needed. The aim of this article is to discuss practical issues related to the diagnostic workup and management of hyponatremia, with particular attention to complex patients, such as those affected by neoplastic diseases. Admittedly, these patients may present several comorbidities, which may cause sodium alterations...
February 7, 2018: Endocrine
https://www.readbyqxmd.com/read/29344107/managing-hyponatremia-in-lung-cancer-latest-evidence-and-clinical-implications
#15
REVIEW
Ilaria Fiordoliva, Tania Meletani, Maria Giuditta Baleani, Silvia Rinaldi, Agnese Savini, Marzia Di Pietro Paolo, Rossana Berardi
Hyponatremia is the most common electrolyte disorder in lung cancer patients. This condition may be related to many causes including incidental medications, concurrent diseases and side effects of antineoplastic treatments or the disease itself. Although not frequently life-threatening, it is usually associated with prolonged hospitalization, delays in scheduled chemotherapy, worsening of patient performance status and quality of life and may also negatively affect treatment response and survival. Most of the available data focus on thoracic tumors, especially small-cell lung cancer (SCLC), where hyponatremia is frequently related to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH)...
November 2017: Therapeutic Advances in Medical Oncology
https://www.readbyqxmd.com/read/29284182/cryptococcosis-and-cryptococcal-meningitis-new-predictors-and-clinical-outcomes-at-a-united-states-academic-medical-centre
#16
Bahar H Kashef Hamadani, Carlos Franco-Paredes, Bruce McCollister, Leland Shapiro, J David Beckham, Andrés F Henao-Martínez
As the diagnosis of cryptococcosis is challenging in low-prevalence settings, uncovering predictive factors can improve early diagnosis and timely treatment. The aim of the study was to relate clinical outcomes to predictive variables for the presence of cryptococcosis. A retrospective case-control study matched by collection date, age and gender at a 1:2 ratio (55 cases and 112 controls) was performed in case patients diagnosed with Cryptococcus infection at the University of Colorado Hospital between 2000 and 2017 (n = 167)...
December 28, 2017: Mycoses
https://www.readbyqxmd.com/read/29222716/childhood-acute-disseminated-encephalomyelitis-an-egyptian-pilot-study
#17
Hamed Ahmed Elkhayat, Omnia Fathy El-Rashidy, Iman Ali Elagouza, Raghda Zaitoun, Yasser Abdel Azeem Abbas
Describing the variable clinical features, laboratory findings, neuroimaging findings, and treatments given to children who presented with ADEM and following them up both clinically and radiologically. 21 patients were recruited: 14 new cases, and 7 old ones presenting over the preceding 5 years (retrospective review of existing data). 11 males and 10 females, with a mean age of 4.4 years ± 2.7 SD, were included. All new patients were subject to full history, examination and a panel of investigations including MRI of the brain...
December 8, 2017: Acta Neurologica Belgica
https://www.readbyqxmd.com/read/29180859/hyponatremia-in-the-elderly-challenges-and-solutions
#18
REVIEW
Theodosios D Filippatos, Andromachi Makri, Moses S Elisaf, George Liamis
Decreased serum sodium concentration is a rather frequent electrolyte disorder in the elderly population because of the presence of factors contributing to increased antidiuretic hormone, the frequent prescription of drugs associated with hyponatremia and also because of other mechanisms such as the "tea and toast" syndrome. The aim of this review is to present certain challenges in the evaluation and treatment of hyponatremia in the elderly population and provide practical solutions. Hyponatremia in elderly subjects is mainly caused by drugs (more frequently thiazides and antidepressants), the syndrome of inappropriate antidiuretic hormone secretion (SIAD) or endocrinopathies; however, hyponatremia is multifactorial in a significant proportion of patients...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29174200/group-2-adrenal-insufficiency-screening-methods-and-confirmation-of-diagnosis
#19
Philippe Chanson, Laurence Guignat, Bernard Goichot, Olivier Chabre, Dinane Samara Boustani, Rachel Reynaud, Dominique Simon, Antoine Tabarin, Damien Gruson, Yves Reznik, Marie-Laure Raffin Sanson
A diagnosis of adrenal insufficiency should be suspected in the presence of a number of non-specific symptoms (fatigue, anorexia, weight loss, hypotension, hyponatremia and hyperkalemia amongst adrenal causes of insufficiency). The diagnosis should be considered in case of pituitary disease or a state of shock. Treatment should be commenced immediately without waiting for confirmation from biochemical tests, which rely on cortisol level at 8am (expected to be low) and on ACTH level (expected to be high in the case of primary adrenal insufficiency)...
December 2017: Annales D'endocrinologie
https://www.readbyqxmd.com/read/29120656/-syndrome-of-inappropriate-antidiuresis-and-the-current-management-of-hyponatremia
#20
Ivica Lazúrová
Hyponatremia defined as serum sodium lower than 135 mmol/L is the most common electrolyte abnormality in outpatients and also in hospitalized patients. It has been documented that hyponatremia is associated with significantly higher morbidity, mortality and longer hospitalization stay. Hyponatremia is manifested by variety of symptoms, from mild up to life threatening conditions. Syndrome of inappropriate antidiuresis (SIAD) is the most common type of hyponatremia. This article presents new aspects in the etiology, diagnosis, differential diagnosis ant treatment of the SIAD according to European guidelines...
December 0: Vnitr̆ní Lékar̆ství
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