True hyponatremia secondary to intravenous immunoglobulin.
Hyponatremia is characterized as either "true hyponatremia," which represents a decrease in the Na(+) concentration in the water phase of plasma, or "pseudohyponatremia," which is due to an increased percentage of protein or lipid in plasma, with a normal plasma water Na(+) concentration ([Na(+)]). Pseudohyponatremia is a known complication of intravenous immunoglobulin (IVIG). Because IVIG has been reported to result in post-infusional hyperproteinemia, IVIG-induced hyponatremia has been attributed to pseudohyponatremia. In this case report, we demonstrate that IVIG therapy can result in true hyponatremia, resulting from sucrose-induced translocation of water from the intracellular compartment (ICF) to the extracellular compartment (ECF), as well as the infusion of a large volume of dilute fluid, in patients with an underlying defect in urinary free water excretion.
Nguyen
Minhtri K
MK
Division of Nephrology, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, Room 7-155 Factor Building, Los Angeles, CA 90095, USA. mtnguyen@mednet.ucla.edu
Rastogi
Anjay
A
Kurtz
Ira
I
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007010:Hyponatremia / Q000209:etiology*; D016756:Immunoglobulins, Intravenous / Q000009:adverse effects*; D008297:Male
D016756:Immunoglobulins, Intravenous