Treating profound hyponatremia: a strategy for controlled correction.
An alcoholic patient presented with profound hyponatremia (serum sodium concentration, 96 mEq/L) caused by the combined effects of a thiazide diuretic, serotonin reuptake inhibitor, beer potomania, and hypovolemia. A computed tomographic scan of the brain was indistinguishable from one obtained 3 weeks earlier when he was normonatremic. Concurrent administration of 3% saline solution and desmopressin controlled the rate of correction to an average of 6 mEq/L daily and resulted in full neurologic recovery without evidence of osmotic demyelination. This case illustrates the value of controlled correction of profound hyponatremia.
Sterns
Richard H
RH
Rochester General Hospital, Nephrology Division, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA. richard.sterns@rochestergeneral.org
Hix
John Kevin
JK
Silver
Stephen
S
D019973:Alcohol-Related Disorders / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D001774:Blood Chemical Analysis; D001927:Brain Diseases / Q000139:chemically induced / Q000517:prevention & control; D003894:Deamino Arginine Vasopressin / Q000008:administration & dosage*; D003711:Demyelinating Diseases / Q000139:chemically induced / Q000517:prevention & control*; D005500:Follow-Up Studies; D006801:Humans; D007010:Hyponatremia / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage; D012720:Severity of Illness Index; D012964:Sodium / Q000378:metabolism; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D012462:Saline Solution, Hypertonic; D012964:Sodium; D003894:Deamino Arginine Vasopressin