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Hypertonic saline hyponatremia

Jaspinder Kaur, Dileep Kumar, Mostafa Alfishawy, Ricardo Lopez, Issac Sachmechi
Paliperidone, an active metabolite of risperidone, is a new atypical antipsychotic agent. Syndrome of inappropriate antidiuretic hormone (SIADH), neuroleptic malignant syndrome (NMS), and rhabdomyolysis are the uncommon side effects of psychotropic drugs. We report a case of 35-year-old male with schizoaffective disorder who was admitted for acute-on-chronic exacerbation of his psychotic disorder for which intramuscular paliperidone 234 mg injection was given. Two days later, the patient developed hyponatremic seizures secondary to SIADH which was treated with hypertonic saline...
2016: Case Reports in Critical Care
Dirk Weismann, Andreas Schneider, Charlotte Höybye
Hyponatremia (HN) is a common condition, with a large number of aetiologies and a complicated treatment. While chronic HN has been shown to be a predictor of poor outcome, sodium-increasing treatments in chronic stable and asymptomatic HN has not proven to increase life expectancy. For symptomatic HN, in contrast, the necessity for urgent treatment has broadly been accepted to avoid the development of fatal cerebral oedema. On the other hand, a too rapid increase of serum sodium in chronic HN may result in cerebral damage due to osmotic demyelination...
September 8, 2016: Endocrine Connections
Bijin Thajudeen, Abdulla K Salahudeen
Hyponatremia is the most frequently observed electrolyte abnormality in clinical practice, and its frequency is almost double in hospitalized cancer patients. As a subset of cancer, hyponatremia is quite common in lung cancer patients, and it is often coupled with the diagnosis of syndrome of inappropriate antidiuretic hormone secretion. The presence of hyponatremia is consequential in that its presence adversely affects cancer patients' prognosis and outcomes. Limited data suggest that correcting hyponatremia in lung cancer patients can increase response to anticancer treatment, may help reduce length of hospital stay and cost, and reduce morbidity and mortality...
2016: Cancer Management and Research
Kerri McGreal, Pooja Budhiraja, Nishank Jain, Alan S L Yu
BACKGROUND: Hyponatremia is a common electrolyte imbalance that clinicians face on a regular basis. SUMMARY: This review aims to discuss four current challenges that can arise when diagnosing and treating hyponatremia: low solute intake, heart failure, exercise-associated hyponatremia, and mild chronic hyponatremia. Low solute intake in a person who already has a urinary concentrating defect will lead to increased retention of free water. The free water retention will cause or worsen hyponatremia that is already present...
June 2016: Kidney Diseases
W Fenske, B Sandner, M Christ-Crain
The syndrome of inappropriate antidiuretic hormone secretion (SIADH), also referred to as syndrome of inappropriate antidiuresis (SIAD), is the most common cause of hyponatremia characterized by extracellular hypotonicity and impaired urine dilution in the absence of any recognizable nonosmotic stimuli for the antidiuretic hormone arginine vasopressin (AVP). Hyponatremia in SIADH is primarily the result of excessive water retention caused by a combination of inappropriate antidiuresis and persistent fluid intake in the presence of impaired osmoregulated inhibition of thirst...
March 2016: Best Practice & Research. Clinical Endocrinology & Metabolism
Xiangyun Zhang, Mingyi Zhao, Wei Du, Dongni Zu, Yingwei Sun, Rongwu Xiang, Jingyu Yang
Hyponatremia, defined as a nonartifactual serum sodium level <135 mmol/L, is the most common fluid and electrolyte abnormality in clinical practice. Traditional managements (fluid restriction, hypertonic saline and loop diuretics, etc.) are difficult to maintain or ineffective. Recently, vasopressin receptor antagonists (VRAs) have shown promise for the treatment of hyponatremia. We aimed to conduct a meta-analysis to evaluate the efficacy and safety of VRAs in patients with euvolemic or hypervolemic hyponatremia...
April 2016: Medicine (Baltimore)
Alessandro Peri, Christian Grohé, Rossana Berardi, Isabelle Runkle
Despite the widespread prevalence of hyponatremia and its deleterious effects on patients, it is often overlooked and consequently undertreated. This set of four cases provides practical advice on how to identify, diagnose, and treat patients with syndrome of inappropriate antidiuretic hormone (SIADH). The first steps that a physician should take when diagnosing a patient with hyponatremia are to assess the severity of neurological symptoms, and check the patient's volemic status in order to determine whether emergency treatment with hypertonic saline is indicated...
March 30, 2016: Endocrine
Arthur J Siegel, Sophie S Forte, Nasir A Bhatti, Steven E Gelda
BACKGROUND: Drug-induced hyponatremia characteristically presents with subtle psychomotor symptoms due to its slow onset, which permits compensatory volume adjustment to hypo-osmolality in the central nervous system. Due mainly to the syndrome of inappropriate antidiuretic hormone secretion (SIADH), this condition readily resolves following discontinuation of the responsible pharmacological agent. Here, we present an unusual case of life-threatening encephalopathy due to adverse drug-related effects, in which a rapid clinical response facilitated emergent treatment to avert life-threatening acute cerebral edema...
2016: American Journal of Case Reports
Daniel Landau, Harry J Hirsch, Varda Gross-Tsur
BACKGROUND: Prader-Willi syndrome is a complex neurogenetic, multisystem disorder. Despite the variable endocrine abnormalities and hypothalamic-pituitary axis dysfunction, hyponatremia has been reported in only a few PWS patients. In previously reported PWS individuals, hyponatremia was associated with abnormal fluid intake or during desmopressin treatment. CASE PRESENTATION: We describe an infant with Prader-Willi syndrome who had severe, prolonged asymptomatic hyponatremia without a history of excessive fluid intake or desmopressin treatment...
2016: BMC Pediatrics
Georgene Singh, Ari Manickam, Manikandan Sethuraman, Ramesh Chandra Rathod
We describe a case of Takotsubo cardiomyopathy in a case of pituitary macroadenoma in acute adrenal crisis. A 48-year-old man presented with acute onset altered sensorium, vomiting, and gasping. On admission, he was unresponsive and hemodynamically unstable. He was intubated and ventilated and resuscitated with fluids and inotropes. The biochemical evaluation revealed hyponatremia, hyperkalemia, and hypocortisolism. Hyponatremia was corrected with 3% hypertonic saline. Contrast enhanced computed tomography (CT) scan of the brain revealed a sellar-suprasellar mass with hypothalamic extension with no evidence of pituitary apoplexy...
December 2015: Indian Journal of Critical Care Medicine
Orkun Tolunay, Tamer Celik, Umit Celik, Mustafa Kömür, Begul Yagci-Kupeli
OBJECTIVE: Cerebral salt-wasting syndrome (CSWS) is a hypovolemic hyponatremia caused by natriuresis and diuresis, of which the exact pathogenesis is unknown. Although CSWS has been more commonly described to be associated with neurosurgical disorders, increasing numbers of patients are diagnosed and new etiological factors are being identified as the awareness of it increases. METHODS: The files of the patients who had been hospitalized and treated with the diagnosis of CSWS at the pediatric critical care unit during the last three years were retrospectively reviewed...
December 2015: Neuro Endocrinology Letters
Yoshinori Goto, Shigenori Wakita, Masashi Yoshimitsu, Satoko Inagaki, Takeshi Kobayashi, Shuichi Kaneko
A 78-year-old man with advanced gastric cancer was treated with S-1 and oxaliplatin chemotherapy. He developed hiccups and nausea, and was diagnosed with hyponatremia (serum Na: 120 mEq/L) on day 6 of the first treatment course. Because of his increased urinary Na excretion and relatively high ADH values, he was subsequently diagnosed with chemotherapy-induced syndrome of inappropriate secretion of antidiuretic hormone. The patient recovered after an infusion of hypertonic saline. Although S-1 was restarted, hyponatremia did not recur...
December 2015: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Amanda Miller, Bonnie Kuehl, Karthik Tennankore, Steven Soroka
BACKGROUND: Hyponatremia is a recognized complication of congestive heart failure (CHF) and is associated with reduced survival. Therefore, early identification and appropriate management of hyponatremia is important. The aim of this study was to determine the general approach amongst Canadian healthcare practitioners and trainees to the identification and management of hyponatremia complicating CHF. METHODS: Respondents completed 15 multiple-choice style questions in 3 case scenarios regarding the approach to management of hyponatremia complicating CHF using an online survey on UKidney...
2016: Canadian Journal of Kidney Health and Disease
Axel Petzold, Giuseppe Citerio, Stephan A Mayer
No abstract text is available yet for this article.
January 21, 2016: New England Journal of Medicine
Lindsay Lief
No abstract text is available yet for this article.
January 21, 2016: New England Journal of Medicine
Horng-Ruey Chua
No abstract text is available yet for this article.
January 21, 2016: New England Journal of Medicine
Julian L Seifter
No abstract text is available yet for this article.
January 21, 2016: New England Journal of Medicine
Michael L Moritz, Juan C Ayus
No abstract text is available yet for this article.
January 21, 2016: New England Journal of Medicine
Piotr Czupryna, Anna Moniuszko, Adam Garkowski, Sławomir Pancewicz, Joanna Zajkowska
AIM: The aim of the study was the evaluation of frequency and origin of hyponatremia in tick borne encephalitis (TBE) in comparison to non-TBE viral meningitis and bacterial meningitis. METHODS: A total of 124 patients aged 18-80 years, with TBE were included to the study. The mild form of TBE was diagnosed in 59 patients, while the severe form was diagnosed in 65 patients. The first control group (VMG) consisted of 72 patients with viral meningitis, but excluded TBE...
2016: Scandinavian Journal of Clinical and Laboratory Investigation
Joseph G Verbalis, Arthur Greenberg, Volker Burst, Jean-Philippe Haymann, Gudmundur Johannsson, Alessandro Peri, Esteban Poch, Joseph A Chiodo, Jiten Dave
BACKGROUND: The syndrome of inappropriate antidiuretic hormone secretion is the most common cause of hyponatremia in clinical practice, but current management of hyponatremia and outcomes in patients with syndrome of inappropriate antidiuretic hormone secretion are not well understood. The objective of the Hyponatremia Registry was to assess the current state of management of hyponatremia due to syndrome of inappropriate antidiuretic hormone secretion in diverse hospital settings, specifically which diagnostic and treatment modalities are currently used and how rapidly and reliably they result in an increase in serum sodium concentration ([Na(+)])...
May 2016: American Journal of Medicine
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