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hyponatremia diagnosis and treatment

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https://www.readbyqxmd.com/read/29284182/cryptococcosis-and-cryptococcal-meningitis-new-predictors-and-clinical-outcomes-at-a-united-states-academic-medical-center
#1
Bahar H Kashef Hamadani, Carlos Franco-Paredes, Bruce McCollister, Leland Shapiro, David Beckham, Andrés F Henao-Martínez
Since 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 matching 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
#2
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
#3
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
#4
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
#5
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...
2017: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/29078838/cerebral-salt-wasting-syndrome-diagnosis-by-urine-sodium-excretion
#6
Allen I Arieff, Ramin Gabbai, Ira D Goldfine
BACKGROUND: Cerebral salt-wasting syndrome (CSWS) was initially described over 60 years ago in hyponatremic patients with a cerebral lesion. However, the diagnostic criteria for CSWS have not been fully established. Thus, when hyponatremia is observed in patients with CSWS, they may be misdiagnosed as having the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). Thus, it is critical to differentiate between these 2 conditions because their treatments are diametrically opposed...
October 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/29075541/unusual-complication-of-multidrug-resistant-tuberculosis
#7
Prerna Sharma, Ravindra Nath Sahay
INTRODUCTION: Capreomycin is a second-line drug often used for multidrug-resistant tuberculosis which can result in nephrotoxic effects similar to other aminoglycosides. We describe a case of capreomycin induced Bartter-like syndrome with hypocalcemic tetany. CASE REPORT: 23-year-old female patient presented with carpopedal spasms and tingling sensations in hands. Patient was being treated with capreomycin for two months for tuberculosis. On further investigation, hypocalcemia, hyponatremia, hypomagnesemia, hypokalemia, and hypochloremic metabolic alkalosis were noted...
2017: Case Reports in Nephrology
https://www.readbyqxmd.com/read/29062486/cardiac-tamponade-in-a-patient-with-autoimmune-polyglandular-syndrome-type-2
#8
Andromachi Vryonidou, Stavroula A Paschou, Fotini Dimitropoulou, Panagiotis Anagnostis, Vasiliki Tzavara, Apostolos Katsivas
We describe a case of a 40-year-old woman who was admitted to the intensive care unit with a rapid onset of dyspnea and orthopnea. She presented progressive weakness, weight loss and secondary amenorrhea during last year, while intermittent fever was present for the last two months. Initial biochemical evaluation showed anemia, hyponatremia and increased C-reactive protein levels. Clinical and echocardiographic evaluation revealed cardiac tamponade, which was treated with pericardiocentesis. Pleural fluid samples were negative for malignancy, tuberculosis or bacterial infection...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28991694/dilemmas-in-the-diagnosis-and-treatment-of-intracranial-tuberculomas
#9
REVIEW
Rajeswari Ramachandran, M Muniyandi, Vijay Iyer, T Sripriya, B Priya, T G Govindarajan
Tuberculosis (TB) remains a major public health problem across the globe. A common form of extrapulmonary TB (EPTB) with high mortality and morbidity is neuro TB or tuberculosis of the nervous system. The management of brain TB remains a big challenge due to the lack of specific diagnostic tools and appropriate treatment guidelines. In this context, this manuscript discusses clinical, diagnostic and treatment dilemmas in the management of intracranial tuberculomas. Brain tuberculoma may occur at any site within the cranium, no part of the brain substance or ventricular surface being exempt...
October 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28988019/acute-intermittent-porphyria-after-right-hemi-colectomy
#10
Shadi Alshammary, Reem Al Dulaijan, Khaldoon Saleh, Hazem Zakaria, Ahmed Eldamati, Norah Alwakeel, Abdulmohsen Al-Mulhim
INTRODUCTION: Acute intermittent porphyria is a rare autosomal dominant metabolic disease. It is caused by a genetic mutation that results in deficiency of porphobilinogen deaminase enzyme, the third enzyme in heme biosynthesis. Acute intermittent porphyria precipitated by surgery is very rare. CASE PRESENTATION: We present a 24 year-old woman who developed acute intermittent porphyria five days after right hemi-colectomy. Her presentation included neuro-visceral and psychiatric manifestations, and severe hyponatremia...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28959072/challenges-in-the-management-of-a-patient-with-myxoedema-coma-in-ghana-a-case-report
#11
Josephine Akpalu, Yacoba Atiase, Ernest Yorke, Henrietta Fiscian, Cecilia Kootin-Sanwu, Albert Akpalu
Myxoedema coma is a rare life-threatening disease, and it is essential that it is managed appropriately to reduce the associated high mortality. However, in the setting where efficient healthcare delivery is hampered by inadequacies, the management of such cases may pose a significant challenge. We present the case of a middle-aged woman diagnosed with myxoedema coma and severe hyponatremia. The case report highlights some of the challenges that may be encountered during the management of myxoedema coma in similar settings and outlines the management strategies undertaken to overcome them in the absence of national guidelines...
March 2017: Ghana Medical Journal
https://www.readbyqxmd.com/read/28953058/albumin-use-in-patients-with-cirrhosis-in-france-results-of-the-albu-live-survey-a-case-for-better-easl-guidelines-diffusion-and-or-revision
#12
Armand Garioud, Jean-François Cadranel, Arnaud Pauwels, Jean-Baptiste Nousbaum, Thierry Thévenot, Thong Dao, Alexandre Louvet, Philippe Sogni, Nathalie Talbodec, Teresa M Antonini, Christophe Bureau, Dominique Thabut, Laure Elkrief, Vincent Jouannaud, Gilles Macaigne, Brigitte Bernard-Chabert, Hortensia Lison, Laurent Alric, Nicolas Carbonell, Héléne Labadie, Xavier Amiot, Armand Abergel, Bertrand Hanslik, Vincent Leroy, Victor De Lédinghen, Jacques Denis
INTRODUCTION: The use of human albumin for the management of cirrhosis has increased. Recommendations have been published for therapeutic paracentesis (TP), spontaneous bacterial peritonitis (SBP), and type 1 hepatorenal syndrome (HRS). The goal of this survey was to assess the prescription practices of French hepatogastroenterologists. METHODS: All hepatogastroenterologists were contacted. The questionnaire evaluated (1) the use of albumin in validated indications and (2) the prescription of albumin for nonvalidated clinical situations...
August 4, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28944149/a-case-of-leprosy-erythema-nodosum-leprosum-and-hemophagocytic-syndrome-a-continuum-of-manifestations-of-same-agent-host-interactions
#13
Prasan Kumar Panda, Ramjas Prajapati, Arvind Kumar, Manisha Jana, Pradeep Immanuel, Pranay Tanwar, Naveet Wig
A young adult man with 4-years history of lepromatous leprosy (received irregularly multidrug therapy) presented with two and half years history of symptoms suggestive of chronic erythema nodosum leprosum (ENL), initially responded to steroids and thalidomide, but later on failed. During the last 2-months, he developed fever, vomiting, and subsequently altered sensorium. On evaluation, he had hepatosplenomegaly, hyponatremia, hyperferritinemia, hemophagocytosis in bone marrow aspiration, lobular panniculitis in skin biopsy, and multiple parenchymal nodules in chest imaging...
August 2017: Intractable & Rare Diseases Research
https://www.readbyqxmd.com/read/28939923/-thyroid-emergencies-thyroid-storm-and-myxedema-coma
#14
REVIEW
C Spitzweg, M Reincke, R Gärtner
Thyroid emergencies are rare life-threatening endocrine conditions resulting from either decompensated thyrotoxicosis (thyroid storm) or severe thyroid hormone deficiency (myxedema coma). Both conditions develop out of a long-standing undiagnosed or untreated hyper- or hypothyroidism, respectively, precipitated by an acute stress-associated event, such as infection, trauma, or surgery. Cardinal features of thyroid storm are myasthenia, cardiovascular symptoms, in particular tachycardia, as well as hyperthermia and central nervous system dysfunction...
October 2017: Der Internist
https://www.readbyqxmd.com/read/28913489/cerebral-salt-wasting-syndrome-in-patients-with-minor-head-trauma-two-case-reports
#15
Gabriela Csipak, Natalia Hagau
We describe two polytrauma patients without severe head trauma who developed Cerebral Salt Wasting Syndrome (CSWS) during their stay in our ICU with natriuresis, hyponatremia and hypovolemia. Hyponatremia encountered in CSWS and the syndrome of inadequate antidiuretic hormone secretion (SIADH) is a common electrolyte finding in patients with severe head trauma, subarachnoid hemorrhage, malignancy and infections of the central nervous system. CSWS was an unexpected electrolyte finding in our patients with minor head trauma without neurological or neurosurgical problems...
October 2016: Romanian Journal of Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28868192/giant-cavernous-carotid-aneurysm-causing-pituitary-dysfunction-pituitary-function-recovery-with-high-flow-bypass
#16
Hideaki Ono, Tomohiro Inoue, Naoto Kunii, Takeo Tanishima, Akira Tamura, Isamu Saito, Nobuhito Saito
BACKGROUND: Giant internal carotid artery (ICA) aneurysms extending into the sellar region, mimicking pituitary tumors, and causing pituitary dysfunction are relatively rare. Open surgery or endovascular treatment can treat these aneurysms, but achieving recovery of endocrine function is difficult. CASE DESCRIPTION: A 56-year-old man presented with giant aneurysm of the ICA causing pituitary impairment, leading to disturbance of consciousness due to hyponatremia...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28810281/-hyponatremia-differential-diagnosis-and-treatment
#17
REVIEW
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
#18
Shermineh Farmand, Jonatan D 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 of hyponatremia. However, most studies have focused on the effect on sodium levels regardless of clinical symptoms, or have 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 hospitalization due to hyponatremia...
August 10, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28798240/tetraparesia-an-unusual-presentation-of-disseminated-tuberculosis
#19
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
#20
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...
November 2017: Cancer Chemotherapy and Pharmacology
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