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Unexplained Hyponatremia: Seek and You Will Find.
MedLine Citation:
PMID:  21212700     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background: Hyponatremia is a common diagnostic challenge. Methods: An index case is presented to discuss the diagnostic approach to chronic and unexplained hyponatremia. Results: The index case concerns a 60-year-old man with chronic hepatitis C and previous alcohol use who was referred because of weight loss, poor dietary intake, dizzy spells, and unexplained hyponatremia (serum sodium 124-129 mmol/l). A low urine sodium concentration (20 mmol/l) and a lowfractional sodium excretion (0.07%) were observed repeatedly, while urine osmolality washigh (>400 mosm/kg). The central questions in this case are: what is the differential diagnosis, which tests are needed to confirm or exclude a diagnosis, and how would you proceed if no obvious cause is found? Conclusions: The diagnosis of this case of unexplained hyponatremia was unexpected, but important because it was treatable. The challenges and caveats of the diagnostic approach to hyponatremia are discussed. A diagnostic algorithm to guide clinicians who are confronted with similar cases is presented.
Authors:
Ewout J Hoorn; Daphne Hotho; Robert Jan Hassing; Robert Zietse
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-1-07
Journal Detail:
Title:  Nephron. Physiology     Volume:  118     ISSN:  1660-2137     ISO Abbreviation:  -     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-1-7     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101159772     Medline TA:  Nephron Physiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  p66-p71     Citation Subset:  -    
Copyright Information:
Copyright © 2011 S. Karger AG, Basel.
Affiliation:
Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands.
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