Resistant hyponatraemia in a patient with follicular lymphoma and heart failure with reduced ejection fraction: a case report.
| Autor: | Butler J; Department of Cardiology, Northern General Hospital, Herries Road, Sheffield S5 7AU, UK., Miro F; Department of Cardiology, Northern General Hospital, Herries Road, Sheffield S5 7AU, UK., Al-Mohammad A; Department of Cardiology, Northern General Hospital, Herries Road, Sheffield S5 7AU, UK. |
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| Jazyk: | angličtina |
| Zdroj: | European heart journal. Case reports [Eur Heart J Case Rep] 2021 May 15; Vol. 5 (5), pp. ytab183. Date of Electronic Publication: 2021 May 15 (Print Publication: 2021). |
| DOI: | 10.1093/ehjcr/ytab183 |
| Abstrakt: | Background: Hyponatraemia is a common problem in patients with heart failure. It can be difficult to treat, especially in the presence of the patient's needs for diuresis and manipulation of the renin-angiotensin-aldosterone system (RAAS). Case Summary: This concerns a 74-year-old woman with follicular lymphoma and severe global left ventricular systolic dysfunction secondary to treatment with R-CHOP chemotherapy. She presented a difficult challenge in the management of her decompensated heart failure alongside hyponatraemia as low as 113 mmol/L. This was resistant to standard treatment. The resistance to usual measures necessitated treatment with Tolvaptan, a selective arginine vasopressin V2 inhibitor used to treat hyponatraemia in syndrome of inappropriate anti-diuretic hormone. This, along with a strict fluid restriction of 500 mL/day, resolved the patient's hyponatraemia and enabled her discharge home on tolerated heart failure treatment. She has now remained stable for almost 12 months. Discussion: The potential causes of hyponatraemia are discussed along with the role of Tolvaptan in its management. (© The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology.) |
| Databáze: | MEDLINE |
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