title: Severe hyponatremia associated with thiazide diuretic use.
abstract: BACKGROUND
  Thiazide diuretics are commonly used as first-line antihypertensive agents. Hyponatremia is a reported, though uncommon, complication of thiazide use. Although the exact mechanism of thiazide-induced hyponatremia (TIH) is unclear, it can be a significant cause of morbidity and mortality.
  
  
  METHODS
  We report a 69-year-old man with generalized weakness beginning 2 weeks after starting hydrochlorothiazide (HCTZ). Evaluation revealed a serum sodium level of 120 mmol/L. The patient was admitted and successfully treated with free water restriction and discontinuation of the HCTZ. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Hyponatremia is an uncommon complication of thiazide diuretic use, which frequently presents with nonspecific symptoms. Identification of TIH is crucial to prevent its potentially life-threatening complications.
authors.affiliation: Department of Emergency Medicine, University of Illinois Hospital & Health Sciences System, University of Illinois College of Medicine, Chicago, Illinois.
authors.forename: Gurkiran K
authors.initials: GK
authors.lastname: Sardar
authors.affiliation: Department of Emergency Medicine, University of Illinois Hospital & Health Sciences System, University of Illinois College of Medicine, Chicago, Illinois.
authors.forename: Wesley P
authors.initials: WP
authors.lastname: Eilbert
mesh_terms: D000368:Aged; D006801:Humans; D006852:Hydrochlorothiazide / Q000009:adverse effects*; D007010:Hyponatremia / Q000139:chemically induced*; D008297:Male; D049993:Sodium Chloride Symporter Inhibitors / Q000009:adverse effects*
chemical_list: D049993:Sodium Chloride Symporter Inhibitors; D006852:Hydrochlorothiazide
keywords: diuretics; hyponatremia; hyponatremia management; thiazide-induced hyponatremia; thiazides