Hyponatremia history and symptoms: Difference between revisions
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{{CMG}}; {{AE}} {{Saeedeh}} | {{CMG}}; {{AE}} {{Saeedeh}} | ||
==Overview== | ==Overview== | ||
Symptoms associated with hyponatremia are caused mostly by impairment of brain function. There is a spectrum of signs from no detectable presentation to death. To evaluate the causes of hyponatremia, careful history has to be taken. Drug history and past medical history can lead to the most common causes of hyponatremia. | |||
==History and Symptoms== | ==History and Symptoms== | ||
* Drug history | * Drug history | ||
* Diet history | * Diet history | ||
* History of volume loss: | * History of [[volume loss]]: [[Diarrhea]], [[vomiting]] | ||
* History of decreased urine output | * History of decreased urine output | ||
* Chronic illnesses: CHF, RF | * Chronic illnesses: [[CHF]], [[Renal failure|RF]] | ||
* History of endocrine disorders | * History of endocrine disorders | ||
* History of malignancy | * History of [[malignancy]] | ||
* History of infectious | * History of [[infectious]] diseases | ||
* History of psychiatric | * History of [[psychiatric]] illnesses | ||
* History of diagnostic procedures or | * History of diagnostic procedures or operations | ||
* History of blood disorders | * History of blood disorders | ||
* History of CNS disorders | * History of CNS disorders | ||
* | *History of pulmonary diseases | ||
===Common Symptoms | *History of genetic diseases: [[Hyperlipidemia]], nephrogenic [[SIADH|SIAD]], [[RTA]] | ||
The clinical signs and symptoms of hyponatremia are related to the degree of brain compensation to hypoosmolarity.Development of cerebral edema, increased intracerebral pressure and cerebral hypoxia are responsible for hyponatremia presentation. Also see the [[Hyponatremia natural history, complications and prognosis#Natural History, Complications, and Prognosis| | *History of [[diabetes]] | ||
*History of GI disorders | |||
To see the different causes of hyponatremia, click [[Hyponatremia causes#Causes|here]]. | |||
===Common Symptoms === | |||
The clinical signs and symptoms of hyponatremia are related to the degree of brain compensation to hypoosmolarity. Development of [[cerebral edema]], increased [[intracerebral pressure]] and [[cerebral hypoxia]] are responsible for hyponatremia presentation. Also see the [[Hyponatremia natural history, complications and prognosis#Natural History, Complications, and Prognosis|complications]] of hyponatremia. | |||
* '''Asymptomatic''' | * '''Asymptomatic''' | ||
* '''Acute neurologic changes:''' seizures, altered mental status, coma , focal neurologic signs | * '''Acute neurologic changes:''' [[seizures]], altered [[mental status]], [[coma]] , [[focal neurologic signs]] like one-sided facial droop, opposite-sided [[hemiparesis]], [[dysarthria]] and [[aphasia]] in hyperacute hyponatremia. <ref name="BalbiSadowski2021">{{cite journal|last1=Balbi|first1=Alanna|last2=Sadowski|first2=Jennifer A.|last3=Torrens|first3=Daniel|last4=Jacoby|first4=Jeanne L.|last5=Yacoub|first5=Hussam A.|last6=Eygnor|first6=Jessica K.|title=Hyperacute hyponatremia mimicking acute ischemic stroke: A case report|journal=The American Journal of Emergency Medicine|year=2021|issn=07356757|doi=10.1016/j.ajem.2021.07.017}}</ref> | ||
* '''Moderate symptoms''' | |||
** [[Nausea]] | |||
** [[Malaise]] | |||
** [[Headache]] | |||
** [[Confusion]] | |||
** Loss of energy and [[fatigue]] | |||
** [[Restlessness]] and [[irritability]] | |||
** [[Muscle weakness]], [[spasms]] or [[cramps]] | |||
** [[Fatigue]] | |||
** [[Lethargy]] | |||
** [[Dizziness]] | |||
** [[Gait disturbances]] | |||
** [[Forgetfulness]] | |||
* '''Severe''' | * '''Severe''' | ||
** Vomiting | ** [[Vomiting]] | ||
** Cardio-respiratory distress | ** Cardio-respiratory distress | ||
** Abnormal and deep somnolence | ** Abnormal and deep [[somnolence]] | ||
** Seizures | ** [[Seizures]] <ref name="HabibHamad2021">{{cite journal|last1=Habib|first1=Mhd Baraa|last2=Hamad|first2=Mohammad Khair|last3=Kalash|first3=Tarif|last4=Ahmed|first4=Ashraf|last5=Mohamed|first5=Mouhand F|title=COVID-19 Pneumonia Complicated by Seizure Due to Severe Hyponatremia|journal=Cureus|year=2021|issn=2168-8184|doi=10.7759/cureus.15603}}</ref> | ||
** Coma (Glasgow Coma Scale 8) | ** [[Coma]] (Glasgow Coma Scale 8) | ||
** Delirium | ** [[Delirium]] | ||
** Impaired consciousness | ** [[Decreased consciousness|Impaired consciousness]] | ||
<br> | <br> | ||
* Mild chronic hyponatremia (plasma sodium 125–135 mEq/L) may cause subtle neurocognitive deficits that can be detected by careful testing ,these deficits improve when the plasma sodium is normalized.<ref>{{Cite journal | * Mild chronic hyponatremia (plasma sodium 125–135 mEq/L) may cause subtle neurocognitive deficits that can be detected by careful testing ,these deficits improve when the plasma sodium is normalized.<ref>{{Cite journal | ||
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}}</ref> | }}</ref> | ||
*COVID-19 pneumonia patients have been found to develop SIADH and severe hyponatremia in some cases causing [[seizures]]. <ref name="HabibHamad2021">{{cite journal|last1=Habib|first1=Mhd Baraa|last2=Hamad|first2=Mohammad Khair|last3=Kalash|first3=Tarif|last4=Ahmed|first4=Ashraf|last5=Mohamed|first5=Mouhand F|title=COVID-19 Pneumonia Complicated by Seizure Due to Severe Hyponatremia|journal=Cureus|year=2021|issn=2168-8184|doi=10.7759/cureus.15603}}</ref> | |||
===Less Common Symptoms=== | ===Less Common Symptoms=== | ||
* Cardiorespiratory arrest | * [[Cardiorespiratory arrest]] | ||
*Death | *Death | ||
*Coma | *[[Coma]] | ||
*Brain damage/ brain edema | *[[Brain damage]]/ [[brain edema]] | ||
*Epileptic seizures | *[[Epileptic seizures]] | ||
*Osmotic demyelinating syndrome | *[[Central pontine myelinolysis|Osmotic demyelinating syndrome]] | ||
==References== | ==References== | ||
Latest revision as of 18:15, 27 July 2021
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Saeedeh Kowsarnia M.D.[2]
Overview
Symptoms associated with hyponatremia are caused mostly by impairment of brain function. There is a spectrum of signs from no detectable presentation to death. To evaluate the causes of hyponatremia, careful history has to be taken. Drug history and past medical history can lead to the most common causes of hyponatremia.
History and Symptoms
- Drug history
- Diet history
- History of volume loss: Diarrhea, vomiting
- History of decreased urine output
- Chronic illnesses: CHF, RF
- History of endocrine disorders
- History of malignancy
- History of infectious diseases
- History of psychiatric illnesses
- History of diagnostic procedures or operations
- History of blood disorders
- History of CNS disorders
- History of pulmonary diseases
- History of genetic diseases: Hyperlipidemia, nephrogenic SIAD, RTA
- History of diabetes
- History of GI disorders
To see the different causes of hyponatremia, click here.
Common Symptoms
The clinical signs and symptoms of hyponatremia are related to the degree of brain compensation to hypoosmolarity. Development of cerebral edema, increased intracerebral pressure and cerebral hypoxia are responsible for hyponatremia presentation. Also see the complications of hyponatremia.
- Asymptomatic
- Acute neurologic changes: seizures, altered mental status, coma , focal neurologic signs like one-sided facial droop, opposite-sided hemiparesis, dysarthria and aphasia in hyperacute hyponatremia. [1]
- Moderate symptoms
- Nausea
- Malaise
- Headache
- Confusion
- Loss of energy and fatigue
- Restlessness and irritability
- Muscle weakness, spasms or cramps
- Fatigue
- Lethargy
- Dizziness
- Gait disturbances
- Forgetfulness
- Severe
- Vomiting
- Cardio-respiratory distress
- Abnormal and deep somnolence
- Seizures [2]
- Coma (Glasgow Coma Scale 8)
- Delirium
- Impaired consciousness
- Mild chronic hyponatremia (plasma sodium 125–135 mEq/L) may cause subtle neurocognitive deficits that can be detected by careful testing ,these deficits improve when the plasma sodium is normalized.[3]
- COVID-19 pneumonia patients have been found to develop SIADH and severe hyponatremia in some cases causing seizures. [2]
Less Common Symptoms
References
- ↑ Balbi, Alanna; Sadowski, Jennifer A.; Torrens, Daniel; Jacoby, Jeanne L.; Yacoub, Hussam A.; Eygnor, Jessica K. (2021). "Hyperacute hyponatremia mimicking acute ischemic stroke: A case report". The American Journal of Emergency Medicine. doi:10.1016/j.ajem.2021.07.017. ISSN 0735-6757.
- ↑ 2.0 2.1 Habib, Mhd Baraa; Hamad, Mohammad Khair; Kalash, Tarif; Ahmed, Ashraf; Mohamed, Mouhand F (2021). "COVID-19 Pneumonia Complicated by Seizure Due to Severe Hyponatremia". Cureus. doi:10.7759/cureus.15603. ISSN 2168-8184.
- ↑ F. C. Bartter & W. B. Schwartz (1967). "The syndrome of inappropriate secretion of antidiuretic hormone". The American journal of medicine. 42 (5): 790–806. PMID 5337379. Unknown parameter
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