Rickettsiosis-associated hyponatremia.
Two patients with hyponatremia (130 mEq/l and 122 mEq/l, respectively), and rickettsial disease are described. The causes of hyponatremia were attributed to rickettsial vasculitis and increased capillary permeability in the first patient and to the syndrome of inappropriate anti-diuretic hormone (ADH) secretion in the second patient. The differentiation between the mechanisms was established by measurement of urinary sodium excretion which was low in the first patient (7 mEq/l) and high in the second patient (60 mEq/l), and levels of ADH that were inappropriately high in the second patient (7-9 pg/ml) in the presence of low plasma osmolality. The differentiation between these causes of hyponatremia has important therapeutic implications.
Department of Internal Medicine E, Chaim Sheba Medical Center, Tel Hashomer, Israel.
M
M
Mouallem
E
E
Friedman
R
R
Pauzner
E
E
Schwartz
E
E
Rubinstein
D000293:Adolescent; D000328:Adult; D002199:Capillary Permeability; D006801:Humans; D007010:Hyponatremia / Q000209:etiology*; D007177:Inappropriate ADH Syndrome / Q000150:complications; D008297:Male; D012282:Rickettsia Infections / Q000150:complications*; D012964:Sodium / Q000652:urine; D014657:Vasculitis / Q000150:complications
D012964:Sodium