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Patients with extra-renal salt losses complicated by hyponatremia were found to be common-place, and consistent with McCance's description, they excreted urine virtually free of sodium. [22] In 1950, Sims et al, published their work that suggest observed relation between hyponatremia and pulmonary tuberculosis.
Central pontine myelinolysis is a neurological condition involving severe damage to the myelin sheath of nerve cells in the pons (an area of the brainstem). It is predominately iatrogenic (treatment-induced), and is characterized by acute paralysis, dysphagia (difficulty swallowing), dysarthria (difficulty speaking), and other neurological symptoms.
A fluid restriction diet is generally medically advised for patients with "heart problems, renal disease, liver damage including cirrhosis, endocrine and adrenal gland issues, elevated stress hormones and hyponatremia". [1] Patients with heart failure are recommended to restrict fluid intake down to 2 quarts per day. [2]
The treatment of hyponatremia depends on the underlying cause. [12] How quickly treatment is required depends on a person's symptoms. [12] Fluids are typically the cornerstone of initial management. [12] In those with severe disease an increase in sodium of about 5 mmol/L over one to four hours is recommended. [12]
This patient was hyponatremic and clinically dehydrated with initial salt therapy not reversing this. Salt restriction resulted in ongoing natriuria. Recommencement of salt therapy subsequently increased serum sodium. Treatment with adrenocorticotropic hormone (ACTH) and deoxycortone acetate (having potent mineralocorticoid activity) had no effect.
Tolvaptan, sold under the brand name Samsca among others, is an aquaretic drug that functions as a selective, competitive vasopressin receptor 2 (V 2) antagonist used to treat hyponatremia (low blood sodium levels) associated with congestive heart failure, cirrhosis, and the syndrome of inappropriate antidiuretic hormone (SIADH).
Treatment is first targeted at the specific metabolic disorder. In general, rasburicase and hydration are the mainstays of treatment in patients with clinical evidence of tumor lysis syndrome. [18] A loop diuretic may also be indicated to maintain appropriate production of urine by the kidneys. [18]
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