Hypernatremia history and symptoms: Difference between revisions

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{{Hypernatremia}}
{{Hypernatremia}}
{{CMG}}'''; Associate Editor-In-Chief:''' {{CZ}}; '''Assistant Editor(s)-In-Chief:''' [[User:Jack Khouri|Jack Khouri]]
{{CMG}}; ''' Associate Editor-In-Chief:''' {{CZ}}; '''Assistant Editor(s)-In-Chief:''' [[User:Jack Khouri|Jack Khouri]]


==Diagnosis==
==Overview==
Diagnosing the etiology of hypernatremia is essential. Symptoms, urine osmolarity and water deprivation studies are all helpful.
The symptoms of hypernatremia are subtle and include [[weakness]] or [[lethargy]]. With more severe elevations of the sodium level, [[seizure]]s and [[coma]] may occur.


==History and Symptoms==
==History==
===Symptoms===
A detailed history is important for the diagnosis of the etiology of hypernatremia.
Clinical manifestations of hypernatremia can be subtle, consisting of [[lethargy]], weakness, irritability, and [[edema]]. With more severe elevations of the sodium level, [[seizure]]s and [[coma]] may occur.


Severe symptoms are usually due to acute elevation of the plasma sodium concentration to above 158 mEq/L, which corresponds to an osmolar gradient of 30-35 mEq/kg between plasma and brain. Beyond that level, the rapid reduction of brain volume can cause rupture of cerebral veins leading to intracerebral and subarachnoid hemorrhage. Values above 180 mEq/L are associated with a high mortality rate, particularly in adults. However such high levels of sodium rarely occur without severe coexisting medical conditions.
Patients having hypernatremia may have a positive history of
* [[diabetes insipidus]]
* [[hyperaldosteronism]]
* [[Cushing's disease]]
* Neurological disorder such as dementia or impaired motor function
* Seizure disorder
* [[malabsorptive disease|Malabsorption]]
* Ingestion of excess sodium salts.  
Hypernatremic patients can also have a recent history of the following diseases:
* [[diarrhea]]


'''To note that if hypernatremia progresses over more than 24 hours, the brain adapts rapidly to plasma hyperosmolarity by the intracellular accumulation of many osmolytes such as amino acids (eg, glutamate)'''.
* [[burns]]
* [[exercise]] ([[increased sweating]])
* [[polyuria]]
* P[[polydypsia|olydypsia]] 


===History===
==== Drug history: ====
A detailed history is important for the diagnosis of the etiology of hypernatremia. It should mention any history of diabetes insipidus, hyperaldosteronism, Cushing's disease, neurologic disease, seizure disorder, malabsorptive disease and ingestion of excess sodium salts. Current diarrhea, burns, exercise (increased sweating), polyuria and polydypsia should be emphasized. Drug history should include diuretic use or ingestion of osmotic agents (eg, mannitol, lactulose).
Patients on the following drugs can also have high sodium levels:
* [[diuretic|Diuretics]]
* Lactulose
 
==Symptoms==
Symptoms of hypernatremia are mainly neuromuscular and are as follows:<ref name="pmid2648664">{{cite journal |vauthors=Hardy RM |title=Hypernatremia |journal=Vet. Clin. North Am. Small Anim. Pract. |volume=19 |issue=2 |pages=231–40 |date=March 1989 |pmid=2648664 |doi= |url=}}</ref><ref name="pmid19517406">{{cite journal |vauthors=Kasai CM, King R |title=Hypernatremia |journal=Compend Contin Educ Vet |volume=31 |issue=4 |pages=E1–6; quiz E7 |date=April 2009 |pmid=19517406 |doi= |url=}}</ref><ref name="pmid28164834">{{cite journal |vauthors=Guillaumin J, DiBartola SP |title=A Quick Reference on Hypernatremia |journal=Vet. Clin. North Am. Small Anim. Pract. |volume=47 |issue=2 |pages=209–212 |date=March 2017 |pmid=28164834 |doi=10.1016/j.cvsm.2016.10.002 |url=}}</ref><ref name="pmid9597713">{{cite journal |vauthors=Marks SL, Taboada J |title=Hypernatremia and hypertonic syndromes |journal=Vet. Clin. North Am. Small Anim. Pract. |volume=28 |issue=3 |pages=533–43 |date=May 1998 |pmid=9597713 |doi= |url=}}</ref><ref name="pmid11727338">{{cite journal |vauthors=Manning AM |title=Electrolyte disorders |journal=Vet. Clin. North Am. Small Anim. Pract. |volume=31 |issue=6 |pages=1289–321, vii–viii |date=November 2001 |pmid=11727338 |doi= |url=}}</ref>
* [[lethargy]]
* Weakness
* Irritability
* [[edema]].  
* [[seizure]]s
* [[coma]]


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}


[[Category:Electrophysiology]]
[[Category:Inborn errors of metabolism]]
[[Category:Cardiology]]
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[[Category:Nephrology]]
[[Category:Electrolyte disturbance]]
[[Category:Electrolyte disturbance]]
[[Category:Blood tests]]
[[Category:Intensive care medicine]]
[[fr:Hypokaliémie]]
[[pl:Hipokaliemia]]
[[pt:Hipocaliémia]]
[[ru:Гипокалиемия]]
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[[Category:Inborn errors of metabolism]]
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Latest revision as of 14:52, 12 May 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Assistant Editor(s)-In-Chief: Jack Khouri

Overview

The symptoms of hypernatremia are subtle and include weakness or lethargy. With more severe elevations of the sodium level, seizures and coma may occur.

History

A detailed history is important for the diagnosis of the etiology of hypernatremia.

Patients having hypernatremia may have a positive history of

Hypernatremic patients can also have a recent history of the following diseases:

Drug history:

Patients on the following drugs can also have high sodium levels:

Symptoms

Symptoms of hypernatremia are mainly neuromuscular and are as follows:[1][2][3][4][5]

References

  1. ↑ Hardy RM (March 1989). "Hypernatremia". Vet. Clin. North Am. Small Anim. Pract. 19 (2): 231–40. PMID 2648664.
  2. ↑ Kasai CM, King R (April 2009). "Hypernatremia". Compend Contin Educ Vet. 31 (4): E1–6, quiz E7. PMID 19517406.
  3. ↑ Guillaumin J, DiBartola SP (March 2017). "A Quick Reference on Hypernatremia". Vet. Clin. North Am. Small Anim. Pract. 47 (2): 209–212. doi:10.1016/j.cvsm.2016.10.002. PMID 28164834.
  4. ↑ Marks SL, Taboada J (May 1998). "Hypernatremia and hypertonic syndromes". Vet. Clin. North Am. Small Anim. Pract. 28 (3): 533–43. PMID 9597713.
  5. ↑ Manning AM (November 2001). "Electrolyte disorders". Vet. Clin. North Am. Small Anim. Pract. 31 (6): 1289–321, vii–viii. PMID 11727338.

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