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hyponatremia diagnosis and treatment

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https://www.readbyqxmd.com/read/28810281/-hyponatremia-differential-diagnosis-and-treatment
#1
Heiner Mönig, Alexander Arlt
Hyponatremia is the most common electrolyte abnormality seen in hospitalized patients, with up to 30 % having a plasma sodium concentration below 135 mmol/l. It is now clear that the clinical problem extends beyond the neurological symptoms, which can be explained by intracerebral osmotic fluid shifts and brain edema. Instead, chronic hyponatremia is associated with impaired gait stability and an increased risk of bone fragility fractures. Moreover, hyponatremia has been demonstrated to be an indicator of poor prognosis in a variety of conditions...
August 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28803926/differences-in-associations-of-antidepressants-and-hospitalization-due-to-hyponatremia
#2
Shermineh Farmand, Jonatan Lindh, Jan Calissendorff, Jakob Skov, Henrik Falhammar, David Nathanson, Buster Mannheimer
Background Selective serotonin reuptake inhibitors (SSRIs) and other antidepressants are important as a cause for hyponatremia. However, most studies have focused on the effect on sodium levels regardless of clinical symptoms or been too small to be able to discriminate between the effects of specific antidepressant drugs. The objective of the present study was to investigate the association between different groups of antidepressants and the risk of hospitalisation due to hyponatremia. Methods In this register based case-control study of patients in the general Swedish population we identified 14 359 individuals with a main diagnosis of hyponatremia...
August 10, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28798240/tetraparesia-an-unusual-presentation-of-disseminated-tuberculosis
#3
Filipa Quaresma, Margarida Bentes Jesus
A 48-year-old man with a 4 months history of asthenia, anorexia, 10 kg weight loss and 1 month of hematuria and dysuria was admitted to another hospital for sudden muscular weakness. He was found to have areflexic tetraparesis and was referred to our hospital.On admission, he was bradycardic, tachypneic, with flaccid tetraplegia. Laboratory results showed metabolic acidemia, severe hyperkalemia and hyponatremia, acute renal dysfunction and sterile pyuria. After hyperkalemia correction, the neurological symptoms resolved...
August 10, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28730291/electrolyte-disorders-with-platinum-based-chemotherapy-mechanisms-manifestations-and-management
#4
REVIEW
Bryan Oronsky, Scott Caroen, Arnold Oronsky, Vaughn E Dobalian, Neil Oronsky, Michelle Lybeck, Tony R Reid, Corey A Carter
Platinum chemotherapy, particularly cisplatin, is commonly associated with electrolyte imbalances, including hypomagnesemia, hypokalemia, hypophosphatemia, hypocalcemia and hyponatremia. The corpus of literature on these dyselectrolytemias is large; the objective of this review is to synthesize the literature and summarize the mechanisms responsible for these particular electrolyte disturbances in the context of platinum-based treatment as well as to present the clinical manifestations and current management strategies for oncologists and primary care physicians, since the latter are increasingly called on to provide care for cancer patients with medical comorbidities...
July 20, 2017: Cancer Chemotherapy and Pharmacology
https://www.readbyqxmd.com/read/28722461/-disorders-of-water-and-electrolyte-metabolism-and-changes-in-acid-base-balance-in-patients-with-ascitic-liver-cirrhosis
#5
Halima Gottfriedová, Miroslava Horáčková, Milena Čáslavská, Julius Špičák, Otto Schück
In patients with advanced cirrhosis with ascites disorders of water and electrolyte metabolism are often present and they are associated with changes in acid-base balance. These changes can be very complicated, their diagnosis and treatment difficult. Dilutional hyponatremia is the most common disorder. Hyponatremia in these patients is associated with increased morbidity and mortality before and after liver transplantation. Other common disorders include hyperchloremic acidosis, hypokalemia, metabolic alkalosis, lactic acidosis, respiratory alkalosis...
2017: Casopís Lékar̆ů C̆eských
https://www.readbyqxmd.com/read/28701428/a-mercury-toxicity-case-complicated-by-hyponatremia-and-abnormal-endocrinological-test-results
#6
Matthew Carter, Abdul Abdi, Fareeha Naz, Farouq Thabet, Arpita Vyas
Mercury (Hg) poisoning is considered a rare disease by the National Institutes of Health and the diagnosis can present great challenges to clinicians. Children who are exposed to Hg can present with a wide variety of symptoms, including acrodynia, tremor, excessive salivation, and psychiatric symptoms, including insomnia. However, endocrinologic manifestations from Hg exposure are less well known. This is a case report of a 12-year-old boy who presented with body rash, irritability, insomnia, and profuse sweating after returning from a summer camp...
August 2017: Pediatrics
https://www.readbyqxmd.com/read/28638573/acute-intermittent-porphyria-a-test-of-clinical-acumen
#7
Rashmi Dhital, Sijan Basnet, Dilli Ram Poudel, Khema Raj Bhusal
Acute intermittent porphyria (AIP) is a rare autosomal dominant hepatic porphyria due to deficiency of hydroxymethylbilane synthase (HMBS), also known as porphobilinogen deaminase leading to accumulation of porphyrin precursors. However, gene defect alone is usually not sufficient to cause an acute attack, and many extrinsic factors play a role. Diagnostic tests are defined, but clinical suspicion is often delayed as symptoms mimic other common conditions. We report a case of a 18-year-old male with severe, persistent, and generalized abdominal pain along with marked hyponatremia, with subsequent development of altered mentation needing intensive care...
March 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28623637/pure-small-cell-recurrent-prostate-cancer-developing-syndrome-of-inappropriate-antidiuretic-hormone-secretion
#8
Giorgia Peverelli, Paolo Grassi
PURPOSE: Pure small cell neuroendocrine carcinoma of the prostate is a rare entity characterized by a poor prognosis due to early metastatic spread as well as resistance to treatment. Considering its increasing occurrence, clinicians should be aware of its aggressive behavior, the relevance of an early diagnosis, and proper management. METHODS: A 71-year-old man treated with brachytherapy for localized low-risk prostate cancer developed widespread disease 7 years later with a prostate-specific antigen-negative neuroendocrine small cell phenotype...
June 14, 2017: Tumori
https://www.readbyqxmd.com/read/28619670/hyponatraemia-diagnosis-and-treatment-clinical-practice-guidelines
#9
Goce Spasovski, Raymond Vanholder, Bruno Allolio, Djillali Annane, Steve Ball, Daniel Bichet, Guy Decaux, Wiebke Fenske, Ewout J Hoorn, Carole Ichai, Michael Joannidis, Alain Soupart, Robert Zietse, Maria Haller, Sabine van der Veer, Wim van Biesen, Evi Nagler, Liliana Gonzalez-Espinoza, Alberto Ortiz
Hyponatremia, defined as a serum sodium concentration <135mmol/l, is the most common water-electrolyte imbalance encountered in clinical practice. It can lead to a wide spectrum of clinical symptoms, from mild to severe or even life threatening, and is associated with increased mortality, morbidity and length of hospital stay. Despite this, the management of hyponatremia patients remains problematic. The prevalence of hyponatremia in a wide variety of conditions and the fact that hyponatremia is managed by clinicians with a broad variety of backgrounds have fostered diverse institution- and specialty-based approaches to diagnosis and treatment...
July 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/28583780/-nephrogenic-syndrome-of-inappropriate-antidiuresis-early-diagnosis-avoids-severe-hyponatremia-complications
#10
A Cailleaux, F Mahieu, C Heinrichs, B Adams, K Ismaili, C Brachet
AIM: Nephrogenic syndrome of inappropriate antidiuresis (NSIAD) is a rare disease characterized by a kidney disability to dilute urine and, as a result, severe recurrent hyponatremia. Due to wide variability in clinical expression, the diagnosis still remains a challenge for clinicians. We report our experience of a case in which NSIAD was diagnosed early. We also stress the importance of early diagnosis and treatment, which protects an infant with NSAID from severe hyponatremia. BACKGROUND: A 1-month-old boy was referred to our hospital for persistent hyponatremia and intense vomiting...
June 2, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28535742/electrolyte-disturbances-in-critically-ill-cancer-patients-an-endocrine-perspective
#11
Maryam I Khan, R Phillip Dellinger, Steven G Waguespack
Electrolyte disturbances are frequently encountered in critically ill oncology patients. Hyponatremia and hypernatremia as well as hypocalcemia and hypercalcemia are among the most commonly encountered electrolyte abnormalities. In the intensive care unit, management of critical electrolyte disturbances is focused on initial evaluation and immediate treatment plan to prevent severe complications. A PubMed search was performed to identify best available evidence for evaluation and management of dysnatremias, hypocalcemia, and hypercalcemia...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28501971/electrolyte-and-acid-base-disturbances-in-end-stage-liver-disease-a-physiopathological-approach
#12
REVIEW
José Víctor Jiménez, Diego Luis Carrillo-Pérez, Rodrigo Rosado-Canto, Ignacio García-Juárez, Aldo Torre, David Kershenobich, Eduardo Carrillo-Maravilla
Electrolyte and acid-base disturbances are frequent in patients with end-stage liver disease; the underlying physiopathological mechanisms are often complex and represent a diagnostic and therapeutic challenge to the physician. Usually, these disorders do not develop in compensated cirrhotic patients, but with the onset of the classic complications of cirrhosis such as ascites, renal failure, spontaneous bacterial peritonitis and variceal bleeding, multiple electrolyte, and acid-base disturbances emerge. Hyponatremia parallels ascites formation and is a well-known trigger of hepatic encephalopathy; its management in this particular population poses a risky challenge due to the high susceptibility of cirrhotic patients to osmotic demyelination...
August 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28482428/-clinical-analysis-of-9-cases-with-anti-leucine-rich-glioma-inactivated-1-protein-antibody-associated-limbic-encephalitis
#13
Y X Zhang, H L Yang, Y Y Wu, C C Wang, X Y Gao, Y Y Shi, H Q Liu, Y Huang, J W Zhang
Objective: This study was to describe the clinical characteristics of Anti-leucine-rich glioma inactivated 1 protein(LGI1) antibody associated limbic encephalitis. Methods: Clinical data including clinical features, laboratory and radiological findings, treatment and prognosis of the 9 patients were analyzed. Results: In all 9 cases, 6 cases experienced epileptic seizure, 5 cases had psychosis, 7 cases presented with memory impairment, 4 cases showed faciobrachial dystonic seizure, 2 had refractory hyponatremia...
May 9, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28479800/factors-determining-the-clinical-spectrum-course-and-response-to-treatment-and-complications-in-seronegative-patients-with-central-nervous-system-tuberculosis
#14
Sadanandavalli Retnaswami Chandra, Sikandar Advani, Ravi Kumar, Chandrajith Prasad, Anupama R Pai
INTRODUCTION: Tuberculous meningitis remains a major health issue in the community affecting young adults of both genders predominantly from rural background. In India, the disease continues to kill 2 people every 3 min or nearly 1000 daily, according to the Tuberculosis Control Society India. Tuberculosis (TB) of central nervous system (CNS) is the most devastating form of TB. As this disease is associated with very high prevalence in young adults and will ultimately contribute to great workforce loss, we decided to assess the factors deciding the disease and its course in our patients...
April 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28469865/a-case-of-congestive-heart-failure-caused-by-secondary-hypocortisolism
#15
Fukuko Nagura, Satoshi Kodera, Naoki Hayakawa, Syunichi Kushida, Junji Kanda
Congestive heart failure caused by secondary hypocortisolism is rare but clinically significant, because its appropriate treatment is effective. Severe hyponatremia with indefinite complaint resembling depression or persisting fever despite antibiotics may be important for establishing this diagnosis.
May 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28444683/-atypical-guillain-barre-syndrome-clustering-is-it-necessary-to-reconsider-the-diagnostic-criteria-and-microbiological-protocol
#16
A Dominguez-Mayoral, C Gutierrez, J M Lopez-Dominguez, S Eichau, J Abril, G Navarro-Mascarell, M A Quesada-Garcia, M Ramos, M Alvarez-Lopez, C Menendez-De Leon, G Izquierdo
INTRODUCTION: Guillain-Barre syndrome is classically defined as a symmetrical ascending acute polyradiculoneuropathy, although there are atypical variants that make diagnosis difficult. CASE REPORTS: The medical data of six patients in our hospital area are collected during the first quarter of 2013. Lumbar punctures, imaging, neurophysiological studies, ganglioside antibodies and serologies have been proposed in all cases. We focus on the atypical features as late hyporeflexia, increased frequency of asymmetry and distal paresis and initial fever...
May 1, 2017: Revista de Neurologia
https://www.readbyqxmd.com/read/28424403/-non-convulsive-status-epilepticus-caused-by-hyponatremia-in-an-elderly-woman-a-case-report
#17
Yoshinori Kurauchi, Masahiro Yasaka, Keisuke Tokunaga, Masaki Saito, Shun Shimohama, Yasushi Okada
We report the case of a 67-year-old woman with non-convulsive status epilepticus (NCSE) due to hyponatremia. She had a history of psychogenic polydipsia but not epilepsy. She was admitted to our hospital with dysbulia. On admission, she was confused and disoriented (Glasgow Coma Scale: 6, E1V1M4). Magnetic resonance imaging of the brain showed no abnormalities. Laboratory test showed hyponatremia (Na<sup>+</sup> level: 115 mEq/L). The electroencephalography (EEG) showed a generalized slow wave of 5 Hz during recording...
April 2017: Brain and Nerve, Shinkei Kenkyū No Shinpo
https://www.readbyqxmd.com/read/28381746/syndrome-of-inappropriate-antidiuretic-hormone-secretion-associated-with-amyotrophic-lateral-sclerosis-in-a-patient-developing-carbon-dioxide-narcosis
#18
Yui Inoue, Takaaki Murakami, Takeshi Nakamura, Kyohei Morita, Daita Kaneda, Ichizo Nishino, Tetsuya Hayashi, Yuya Shinoto, Tomonobu Hatoko, Tomoko Kato, Shin Yonemitsu, Seiji Muro, Shogo Oki
We report a rare case of syndrome of inappropriate antidiuretic hormone secretion (SIADH) associated with amyotrophic lateral sclerosis (ALS). A 69-year-old man was admitted to our hospital with sustained hyponatremia. Hyposmolality with elevated urinary osmolality and sodium excretion was observed, which indicated SIADH. The treatment for SIADH was challenging; the patient developed carbon dioxide narcosis, which led to the diagnosis of ALS. After the initiation of noninvasive positive-pressure ventilation, the patient's serum sodium concentration normalized and became stable...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28368858/epidemiological-evaluation-of-mediterranean-spotted-fever-in-children-of-the-karak-province-in-south-jordan
#19
Omar Nafi, Yasseen Tarawnah, Amjad Tarawnah
INTRODUCTION: The aim of this study was to describe the epidemiological patterns of Mediterranean spotted fever (MSF) as well as its treatment and outcomes in children in south Jordan. METHODOLOGY: A retrospective observational study was conducted from June 2013 to December 2015. Data regarding demographics, clinical presentation, laboratory findings, treatment, and outcomes were collected. RESULTS: In total, 35 male and 20 female patients (mean age: 6 years ± 3...
March 31, 2017: Journal of Infection in Developing Countries
https://www.readbyqxmd.com/read/28338570/a-case-of-all-developing-posterior-reversible-encephalopathy-secondary-to-hyponatremia
#20
Nilgun Eroglu, Aysenur Bahadir, Erol Erduran
Posterior reversible encephalopathy syndrome (PRES), may be due to different causes. It may develop secondary to hypertension, renal decompensation, electrolyte imbalance, and chemotherapeutic drugs. We describe a case of acute lymphoblastic leukemia in which PRES developed secondary to hyponatremia despite being normotensive during receipt of chemotherapy. Magnetic resonance imaging findings were suggestive of PRES. Partial diffusion restriction was observed in lesions in the bilateral occipitoparietal regions and the cerebellum...
March 23, 2017: Journal of Pediatric Hematology/oncology
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