The diagnosis of pituitary dysfunction is very difficult in inpatients with liver cirrhosis, because the symptoms are intricate and similar. We here report a case of a male patient complaining of fatigue and anorexia for more than two years. On duration of hospital stay, hyponatremia was irreformable. Magnetic resonance imaging of the pituitary revealed the presence of cystic pituitary and abnormal signal in the left frontal lobe. The patient was also suspected to be infective endocarditis. Recognition of this unusual complication of this condition is important for the patients with chronic liver disease.
Endocarditis ; diagnosis ; Humans ; Hyponatremia ; diagnosis ; Liver Cirrhosis ; complications ; Male ; Middle Aged ; Pituitary Diseases ; diagnosis

Aged ; Humans ; Hyponatremia ; diagnosis ; Inappropriate ADH Syndrome ; diagnosis ; Lung Neoplasms ; diagnosis

Diagnosis, Differential ; Humans ; Hyponatremia ; diagnosis ; etiology ; therapy ; Inappropriate ADH Syndrome ; diagnosis ; etiology ; therapy

No abstract available.
*Asian Continental Ancestry Group ; Female ; Heart Failure/*diagnosis ; *Hospitalization ; Humans ; Hyponatremia/*diagnosis ; Male ; Sodium/*blood

An 18-day-old male infant was admitted to the hospital due to recurrent hyperkalemia for more than 10 days. The neonate had milk refusal and dyspnea. The blood gas analysis revealed recurrent hyperkalemia, hyponatremia and metabolic acidosis. Adrenocortical hormone replacement therapy was ineffective. Additional tests showed a significant increase in aldosterone levels. Family whole exome sequencing revealed that the infant had compound heterozygous in the SCNNIA gene, inherited from both parents. The infant was diagnosed with neonatal systemic pseudohypoaldosteronism type I. The infant's electrolyte levels were stabilized through treatment with sodium polystyrene sulfonate and sodium supplement. The infant was discharged upon clinical recovery. This study provides a focused description of differential diagnosis of salt-losing syndrome in infants and introduces the multidisciplinary management of neonatal systemic pseudohypoaldosteronism type I.
Infant ; Infant, Newborn ; Humans ; Male ; Pseudohypoaldosteronism/genetics* ; Hyperkalemia/etiology* ; Hyponatremia/diagnosis* ; Diagnosis, Differential

In this narrative review we focus on acute symptomatic seizures occurring in subjects with electrolyte disturbances. Quite surprisingly, despite its clinical relevance, this issue has received very little attention in the scientific literature. Electrolyte abnormalities are commonly encountered in clinical daily practice, and their diagnosis relies on routine laboratory findings. Acute and severe electrolyte imbalances can manifest with seizures, which may be the sole presenting symptom. Seizures are more frequently observed in patients with sodium disorders (especially hyponatremia), hypocalcemia, and hypomagnesemia. They do not entail a diagnosis of epilepsy, but are classified as acute symptomatic seizures. EEG has little specificity in differentiating between various electrolyte disturbances. The prominent EEG feature is slowing of the normal background activity, although other EEG findings, including various epileptiform abnormalities may occur. An accurate and prompt diagnosis should be established for a successful management of seizures, as rapid identification and correction of the underlying electrolyte disturbance (rather than an antiepileptic treatment) are of crucial importance in the control of seizures and prevention of permanent brain damage.
Brain ; Diagnosis ; Electroencephalography ; Epilepsy ; Humans ; Hypernatremia ; Hypocalcemia ; Hyponatremia ; Seizures* ; Sensitivity and Specificity ; Sodium

In hyponatremic patients, the assessment of extracellular fluid volume plays an essential step in diagnosing the etiology of hyponatremia and deciding how to manage it. Although various laboratory tests and diagnostic procedures have been developed for differential diagnosis of hyponatremia, there still are limits to the evaluation of the status of extracellular fluid volume due to the data that overlaps each other, leading to the difficulty in diagnosing between euvolemia and hypovolemia. Also, there is no consensus about how to guide the type and amount of fluid therapy despite many formulas including Adrogue-Madias and Barsoum-Levine formulas have been suggested. Hereby, we are reporting two hyponatremic patients (102 and 105 mEq/L) admitted simultaneously with indistinct volume status on initial clinical and laboratory examinations, but were clarified as euvolemic hyponatremia (syndrome of inappropriate antidiuretic hormone secretion) in one and hypovolemic hyponatremia in the other case after sequential intravenous saline (2 L over 24 hrs) and oral water (20 mL/kg) loading tests. When serum sodium values calculated by the above-mentioned two formulas were compared with actually measured ones during saline loading test in these cases, the Barsoum-Levine formula revealed almost no discrepancy between both the values while the Adrogue-Madias formula underestimated the measured value.
Consensus ; Diagnosis, Differential ; Extracellular Fluid ; Fluid Therapy ; Humans ; Hyponatremia ; Hypovolemia ; Inappropriate ADH Syndrome ; Sodium ; Water

Authors report a case of syndrome of inappropriate antidiuretic hormone(SIADH) associated with sertraline. A 77 years-old male patient showed decreased serum & urine osmolality with symptoms of nausea and anorexia after the ingestion of sertraline, 50 mg for four days, which led to the diagnosis of SIADH. The symptoms of nausea and anorexia improved as serum osmolality improved in several days after discontinuation of sertraline. It is recommended to check serum Na level routinely at the initial treatment when patients on SRRI aggrevate in symptom, have a past history of hyponatremia, or are old.
Aged ; Anorexia ; Diagnosis ; Eating ; Humans ; Hyponatremia ; Inappropriate ADH Syndrome ; Male ; Nausea ; Osmolar Concentration ; Sertraline*

Hypothyroidism is widely accepted as a cause of hyponatremia, but severe hyponatremia in hypothyroidism is clinically rare. We report a case of 74-year-old female patient presented with severe hyponatremia and hypothyroidism. Hyponatremia gradually improved with water restriction and hypertonic sodium infusion prior to the initiation of thyroid hormone replacement. After a diagnosis of Hashimoto's thyroiditis had been made, the patient was treated with levothyroxine. She remained well on maintenance dose of levothyroxine with euthyroid and normal serum sodium level.
Aged ; Diagnosis ; Female ; Humans ; Hyponatremia* ; Hypothyroidism* ; Sodium ; Thyroid Gland ; Thyroid Hormones ; Thyroiditis ; Thyroxine ; Water

Idiopathic granulomatous hypophysitis is a chronic inflammation of the pituitary gland. It has a rare occurrence and is diagnosed only on pathologic examination. We report a case of a 60-year-old patient presenting with headache, vomiting and isolated hyponatremia. MRI study showed a space occupying lesion of the pituitary gland with a marked enhancement after gadolinium injection. Pituitary biopsy was consistent with the diagnosis of idiopathic granulomatous hypophysitis. The aim of this case report is to discuss the variable clinical and radiological aspect of the disease.
Biopsy ; Diagnosis ; Gadolinium ; Headache ; Humans ; Hyponatremia ; Inflammation ; Magnetic Resonance Imaging ; Middle Aged ; Pituitary Gland ; Vomiting