title: Severe hyponatremia associated with pre-eclampsia.
abstract: BACKGROUND
  Pre-eclampsia associated hyponatraemia is a very rare condition that can potentially lead to serious maternal and fetal complications and that constitute a diagnostic and therapeutic challenge even for an experienced physician.
  
  
  METHODS
  A 25-year old female presented to the clinic at 25.3 weeks of gestation with mild physical signs of edema along with hypertension, proteinuria, and a severe hyponatremia (113 mEq/L). Hyponatremia was classified as hypervolemic and resolved 72 hours after the delivery with water restriction.
  
  
  CONCLUSIONS
  The pathogenesis of pre-eclampsia associated hyponatremia is relatively unknown. A non-osmotic stimulation of vasopresin release in the setting of a hypervolemic state with low effective circulating plasma volume is thought to be the main mechanism. Advanced maternal age and nephrotic range proteinuria have been postulated as risk factors, but their causal role remains unclear. Fluid restriction is a reasonable treatment, and maternal outcomes are favourable. This condition is a rare indication for urgent delivery, but neonatal outcomes are variable.
authors.affiliation: Departamento de Medicina Interna, Hospital Universitario Dr. José E. González, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México. crcamara83@hotmail.com
authors.forename: Carlos R
authors.initials: CR
authors.lastname: Camara-Lemarroy
authors.forename: Alejandro
authors.initials: A
authors.lastname: de Leon-Cruz
authors.forename: Rene
authors.initials: R
authors.lastname: Rodriguez-Gutierrez
authors.forename: Dionicio A
authors.initials: DA
authors.lastname: Galarza-Delgado
mesh_terms: D000328:Adult; D004487:Edema / Q000175:diagnosis / Q000209:etiology; D005260:Female; D006801:Humans; D007010:Hyponatremia / Q000150:complications / Q000175:diagnosis*; D011225:Pre-Eclampsia / Q000175:diagnosis*; D011247:Pregnancy; D059285:Pregnancy, Twin; D012720:Severity of Illness Index