| Popis: |
Hyponatremia is a common electrolyte disorder in hospitalized patients. In the case of repetitive biochemically confirmed hyponatremia, it is necessary to find its cause. Case report: a 56-year-old woman was admitted to hospital due to leg cramps and malaise. Routine biochemical analysis revealed hypotonic hyponatremia and Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) was suspected. The cause of hyponatremia was not discovered by means of evaluating SIADH. The patient was simptomatically treated, and discharged in better general condition, with partially corrected hyponatremia. She was advised to restrict water intake and to repeat serum electrolytes and BUN regularly. Four months later, she presented with dyspnea and hyperglycemic syndrome, she was confused and her life was threatened. Beside severe hyponatremia and hyperglycemia, an urgent abdominal ultrasonography showed liver secondaries. Shortly after admission, the patient passed away. Unfortunately, the patient's family refused an autopsy, so the origin of neoplasia has remained unknown. It is necessary to do a thorough clinical evaluation of hypotonic hyponatremia. SIADH, as the most frequent cause of hypotonic hyponatremia, is often a paraneoplastic syndrome. Careful correction of hypotonic hyponatremia and management of the underlying disease is the mainstay of SIADH treatment. |
