Medicine:Isotonic hyponatremia
| Isotonic hyponatremia | |
|---|---|
| Specialty | Internal medicine |
Isotonic hyponatremia is a form of hyponatremia with mOsm measured between 280 and 295. It can be associated with pseudohyponatremia, or with isotonic infusion of glucose or mannitol.[1]
Pseudohyponatremia
Certain conditions, such as extraordinarily high blood levels of lipid (hyperlipidemia/hypertriglyceridemia) or protein (hyperparaproteinemia), magnify the electrolyte exclusion effect. This interferes with the measurement of serum sodium concentration by certain methods, leading to an erroneously low measurement of sodium, or pseudohyponatremia. The methods affected are the flame-photometric and indirect (but not direct) ion-selective electrode assays.[2][3] This is distinct from a true dilutional hyponatremia that can be caused by an osmotic shift of water from cells to the bloodstream after large infusions of mannitol or maltose-containing intravenous immunoglobulin.[4] However, intravenous immunoglobulin infusion may lead to pseudohyponatremia by increasing viscosity.[5]
It is associated with hyperlipidemia more frequently than with elevated protein.[6]
References
- ↑ Gottschlich, Michele M.; Matarese, Laura E. (2003). Contemporary nutrition support practice: a clinical guide. Philadelphia: Saunders. pp. 130. ISBN 0-7216-9357-1.
- ↑ "Pseudohyponatremia: a reappraisal". The American Journal of Medicine 86 (3): 315–8. Mar 1989. doi:10.1016/0002-9343(89)90302-1. PMID 2645773.
- ↑ "A new method for determining plasma water content: application in pseudohyponatremia". American Journal of Physiology. Renal Physiology 292 (5): F1652–6. May 2007. doi:10.1152/ajprenal.00493.2006. PMID 17299138.
- ↑ Aziz, Fahad; Sam, Ramin; Lew, Susie Q.; Massie, Larry; Misra, Madhukar; Roumelioti, Maria-Eleni; Argyropoulos, Christos P.; Ing, Todd S. et al. (2023-06-15). "Pseudohyponatremia: Mechanism, Diagnosis, Clinical Associations and Management". Journal of Clinical Medicine (MDPI AG) 12 (12): 4076. doi:10.3390/jcm12124076. ISSN 2077-0383. PMID 37373769.
- ↑ Steinberger, Beth A.; Ford, Stephen M.; Coleman, Teresa A. (2003-05-09). "Intravenous immunoglobulin therapy results in post-infusional hyperproteinemia, increased serum viscosity, and pseudohyponatremia". American Journal of Hematology (Wiley) 73 (2): 97–100. doi:10.1002/ajh.10325. ISSN 0361-8609. PMID 12749010.
- ↑ "Pseudohyponatremia in a patient with HIV and hepatitis C coinfection". Journal of General Internal Medicine 23 (2): 202–5. Feb 2008. doi:10.1007/s11606-007-0446-3. PMID 17994269.
External links
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Template:Electrolyte abnormalities
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