Treating double-digit hyponatremia: walking a tight rope
The Egyptian Journal of Internal Medicine volume 27, pages 121–122 (2015)
We report the case of a diabetic patient who presented with severe hyponatremia (serum sodium concentration of 88 mEq/l) caused by hypovolemia and thiazide diuretic use. His serum sodium levels were gradually corrected using a combination of isotonic and hypotonic fluids based on urine output and rate of rise in sodium levels. The patient had complete recovery without any evidence of osmotic demyelination.
Mohmand HK, Issa D, Ahmad Z, Cappuccio JD, Kouides RW, Sterns RH. Hypertonic saline for hyponatremia: risk of inadvertent overcorrection. Clin J Am Soc Nephrol 2007; 2: 1110–1117.
Soupart A, Ngassa M, Decaux G. Therapeutic relowering of the serum sodium in a patient after excessive correction of hyponatremia. Clin Nephrol 1999; 51: 383–386.
Sterns RH, Hix JK, Silver S. Treating profound hyponatremia: a strategy for controlled correction. Am J Kidney Dis 2010; 56: 774–779.
Iioshi M, Sakuragi T, Higa K, Hamada T. Severe hyponatremia during transurethral resection of prostate. Masui 2005; 54: 414–417.
Walker GV, Peterson MC. Survival in a patient with severe paraneoplastic hyponatremia: a case report. Cases J 2008; 1: 248.
Croxson M, Lucas J, Bagg W. Diluting delirium. N Z Med J 2005; 118: U1661.
Hayashi T, Ishida Y, Miyashita T, Kiyokawa H, Kimura A, Kondo T. Fatal water intoxication in a schizophrenic patient – an autopsy case. J Clin Forensic Med 2005; 12: 157–159.
This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
About this article
Cite this article
Kulkarni, M., Kadri, P., Sannegowda, R.B. et al. Treating double-digit hyponatremia: walking a tight rope. Egypt J Intern Med 27, 121–122 (2015). https://doi.org/10.4103/1110-7782.164644