Rapid Correction of Chronic Hyponatremia Secondary to Psychogenic Polydipsia

2016 ◽  
Author(s):  
Kellie L. Nelson ◽  
Varun Monga ◽  
Ashish Sharma ◽  
Thomas J. Blount
Keyword(s):  
Psychogenic Polydipsia ◽  
Chronic Hyponatremia ◽  
Rapid Correction

Suspected myelinolysis following rapid correction of hyponatremia in a dog

1999 ◽  
Vol 35 (6) ◽  
pp. 493-497 ◽  
Author(s):  
RK Churcher ◽  
AD Watson ◽  
A Eaton
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Neurological Dysfunction ◽  
Laboratory Findings ◽  
Neurological Signs ◽  
Therapeutic Guidelines ◽  
Chronic Hyponatremia ◽  
Iatrogenic Damage ◽  
Gastrointestinal Parasitism ◽  
Rapid Correction

A dog developed signs of neurological dysfunction five days after rapid correction of severe electrolyte derangements, including hyponatremia, caused by gastrointestinal parasitism (i.e., trichuriasis). History, laboratory findings, and onset of neurological signs following correction of hyponatremia led to a diagnosis of myelinolysis. Myelinolysis is a noninflammatory, demyelinating brain disease caused by sudden, upward osmotic shifts in central nervous system plasma, often a result of rapid correction of chronic hyponatremia. The pathogenesis is complex, but recovery is possible. Iatrogenic damage due to myelinolysis can be avoided by adherence to therapeutic guidelines for correction of chronic hyponatremia.

scholarly journals Relowering of Serum Na for Osmotic Demyelinating Syndrome

2012 ◽  
Vol 2012 ◽  
pp. 1-2 ◽  
Author(s):  
Hideomi Yamada ◽  
Koji Takano ◽  
Nobuhiro Ayuzawa ◽  
George Seki ◽  
Toshiro Fujita
Keyword(s):  
Serum Sodium ◽  
Central Pontine Myelinolysis ◽  
Supportive Therapy ◽  
Chronic Hyponatremia ◽  
Pontine Myelinolysis ◽  
Extreme Care ◽  
The Brain ◽  
Osmotic Demyelinating Syndrome ◽  
Central Pontine ◽  
Rapid Correction

We report a case in whom slow correction of hyponatremia (5 mmol/day for 3 days) induced central pontine myelinolysis (CPM). After the diagnosis was confirmed by imaging, we started to relower serum Na that completely recovered the sign and symptoms of CPM. Rapid correction of serum sodium is known to be associated with CPM. However, it may occur even after slow correction of hyponatremia. Currently, there is no standard therapy for CPM other than supportive therapy. Other therapy includes sterioid, plasmaphresis and IVIG, but these therapies have not been shown to be particularly effective. The pathophysiology of CPM is related to a relative dehydration of the brain during the correction of hyponatremia, resulting in cell death and demyelination, therefore gentle rehydration with lowering serum sodium may not be an unreasonable therapy. The present case provides supportive evidence that reinduction of hyponatremia is effective in treating CPM if started immediately after the diagnosis is suggested. The present case tells us that severe chronic hyponatremia must be managed with extreme care especially in patients with chronic debilitating illness and that relowering serum Na is a treatment of choice when CPM is suggested.

Sign in / Sign up

Export Citation Format

Share Document