Tonicity Matters, Especially in Complex Hyponatremia Resulting from Pseudo-, Trans-locational, and True Hypotonic Hyponatremia: An Educational Case Report

Serum tonicity is defined by the serum concentrations of sodium (sNa) and glucose, which can promote free water movement across intra/extracellular compartments. Rapid changes in serum tonicity can cause brain damage. We herein report an educational case of a patient with hyponatremia (sNa: 112 mEq/...

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Autores principales: Ogata, Masatomo, Morikubo, Satoru, Imai, Naohiko, Shibagaki, Yugo, Yazawa, Masahiko
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society of Internal Medicine 2021
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9177352/
https://www.ncbi.nlm.nih.gov/pubmed/34670899
http://dx.doi.org/10.2169/internalmedicine.8285-21
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author Ogata, Masatomo
Morikubo, Satoru
Imai, Naohiko
Shibagaki, Yugo
Yazawa, Masahiko
author_facet Ogata, Masatomo
Morikubo, Satoru
Imai, Naohiko
Shibagaki, Yugo
Yazawa, Masahiko
author_sort Ogata, Masatomo
collection PubMed
description Serum tonicity is defined by the serum concentrations of sodium (sNa) and glucose, which can promote free water movement across intra/extracellular compartments. Rapid changes in serum tonicity can cause brain damage. We herein report an educational case of a patient with hyponatremia (sNa: 112 mEq/L) concomitant with acute alcoholic pancreatitis. The cause of hyponatremia was considered complex. Pseudo- and trans-locational natremia was secondary to hyperglycemia (721 mg/dL) and hypertriglyceridemia (1,768 mg/dL), respectively, and true hypotonic hyponatremia. Regarding sNa correction, rapid correction was suspected. However, this was safely managed by monitoring tonicity (not sNa or osmolarity), thereby avoiding brain damage.
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spelling pubmed-91773522022-07-05 Tonicity Matters, Especially in Complex Hyponatremia Resulting from Pseudo-, Trans-locational, and True Hypotonic Hyponatremia: An Educational Case Report Ogata, Masatomo Morikubo, Satoru Imai, Naohiko Shibagaki, Yugo Yazawa, Masahiko Intern Med Case Report Serum tonicity is defined by the serum concentrations of sodium (sNa) and glucose, which can promote free water movement across intra/extracellular compartments. Rapid changes in serum tonicity can cause brain damage. We herein report an educational case of a patient with hyponatremia (sNa: 112 mEq/L) concomitant with acute alcoholic pancreatitis. The cause of hyponatremia was considered complex. Pseudo- and trans-locational natremia was secondary to hyperglycemia (721 mg/dL) and hypertriglyceridemia (1,768 mg/dL), respectively, and true hypotonic hyponatremia. Regarding sNa correction, rapid correction was suspected. However, this was safely managed by monitoring tonicity (not sNa or osmolarity), thereby avoiding brain damage. The Japanese Society of Internal Medicine 2021-10-19 2022-05-15 /pmc/articles/PMC9177352/ /pubmed/34670899 http://dx.doi.org/10.2169/internalmedicine.8285-21 Text en Copyright © 2022 by The Japanese Society of Internal Medicine https://creativecommons.org/licenses/by-nc-nd/4.0/The Internal Medicine is an Open Access journal distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Ogata, Masatomo
Morikubo, Satoru
Imai, Naohiko
Shibagaki, Yugo
Yazawa, Masahiko
Tonicity Matters, Especially in Complex Hyponatremia Resulting from Pseudo-, Trans-locational, and True Hypotonic Hyponatremia: An Educational Case Report
title Tonicity Matters, Especially in Complex Hyponatremia Resulting from Pseudo-, Trans-locational, and True Hypotonic Hyponatremia: An Educational Case Report
title_full Tonicity Matters, Especially in Complex Hyponatremia Resulting from Pseudo-, Trans-locational, and True Hypotonic Hyponatremia: An Educational Case Report
title_fullStr Tonicity Matters, Especially in Complex Hyponatremia Resulting from Pseudo-, Trans-locational, and True Hypotonic Hyponatremia: An Educational Case Report
title_full_unstemmed Tonicity Matters, Especially in Complex Hyponatremia Resulting from Pseudo-, Trans-locational, and True Hypotonic Hyponatremia: An Educational Case Report
title_short Tonicity Matters, Especially in Complex Hyponatremia Resulting from Pseudo-, Trans-locational, and True Hypotonic Hyponatremia: An Educational Case Report
title_sort tonicity matters, especially in complex hyponatremia resulting from pseudo-, trans-locational, and true hypotonic hyponatremia: an educational case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9177352/
https://www.ncbi.nlm.nih.gov/pubmed/34670899
http://dx.doi.org/10.2169/internalmedicine.8285-21
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