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[Symptomatic hyponatremia in a 43-year-old woman after a skiing accident with head injuries].

Abstract

This article reports the case of a 43-year-old woman who presented to the emergency room with headache and paresthesia after a fall on the head while skiing. She had clinical signs of volume depletion and blood test showed severe hyponatremia. Cerebral imaging was unremarkable. The diagnosis of cerebral salt-wasting syndrome (CSWS) was made, which is defined by the presence of extracellular volume depletion due to a tubular defect in renal sodium transport in patients with normal adrenal and thyroid function. The disease is mostly secondary to a neurological disease or head trauma. The patient rapidly improved after volume therapy and treatment with mineralocorticoids. The differentiation of CSWS from the syndrome of inappropriate antidiuretic hormone (SIADH) secretion can be challenging but the distinction is important because treatment options are very different.

Authors+Show Affiliations

Klinik für Innere Medizin I - Sektion Nephrologie, Zentrum für Innere Medizin, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland. martin.kaechele@uniklinik-ulm.de.Klinik für Innere Medizin I - Sektion Endokrinologie, Zentrum für Innere Medizin, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland.Klinik für Innere Medizin I - Sektion Endokrinologie, Zentrum für Innere Medizin, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland.Klinik für Innere Medizin I - Sektion Nephrologie, Zentrum für Innere Medizin, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland.Klinik für Innere Medizin I - Sektion Endokrinologie, Zentrum für Innere Medizin, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland.Klinik für Innere Medizin I - Sektion Nephrologie, Zentrum für Innere Medizin, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland.

Pub Type(s)

English Abstract
Journal Article

Language

ger

PubMed ID

31673730

Citation

Kächele, M, et al. "[Symptomatic Hyponatremia in a 43-year-old Woman After a Skiing Accident With Head Injuries]." Der Internist, 2019.
Kächele M, van Erp R, Schmid K, et al. [Symptomatic hyponatremia in a 43-year-old woman after a skiing accident with head injuries]. Internist (Berl). 2019.
Kächele, M., van Erp, R., Schmid, K., Bettac, L., Wagner, M., & Schröppel, B. (2019). [Symptomatic hyponatremia in a 43-year-old woman after a skiing accident with head injuries]. Der Internist, doi:10.1007/s00108-019-00697-9.
Kächele M, et al. [Symptomatic Hyponatremia in a 43-year-old Woman After a Skiing Accident With Head Injuries]. Internist (Berl). 2019 Oct 30; PubMed PMID: 31673730.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Symptomatic hyponatremia in a 43-year-old woman after a skiing accident with head injuries]. AU - Kächele,M, AU - van Erp,R, AU - Schmid,K, AU - Bettac,L, AU - Wagner,M, AU - Schröppel,B, Y1 - 2019/10/30/ PY - 2019/11/2/entrez KW - Cerebral salt wasting KW - Electrolytes KW - Fluid therapy KW - Hypophosphatemia KW - Syndrome of inappropriate antidiuretic hormone secretion JF - Der Internist JO - Internist (Berl) N2 - This article reports the case of a 43-year-old woman who presented to the emergency room with headache and paresthesia after a fall on the head while skiing. She had clinical signs of volume depletion and blood test showed severe hyponatremia. Cerebral imaging was unremarkable. The diagnosis of cerebral salt-wasting syndrome (CSWS) was made, which is defined by the presence of extracellular volume depletion due to a tubular defect in renal sodium transport in patients with normal adrenal and thyroid function. The disease is mostly secondary to a neurological disease or head trauma. The patient rapidly improved after volume therapy and treatment with mineralocorticoids. The differentiation of CSWS from the syndrome of inappropriate antidiuretic hormone (SIADH) secretion can be challenging but the distinction is important because treatment options are very different. SN - 1432-1289 UR - https://www.unboundmedicine.com/medline/citation/31673730/[Symptomatic_hyponatremia_in_a_43-year-old_woman_after_a_skiing_accident_with_head_injuries] L2 - https://dx.doi.org/10.1007/s00108-019-00697-9 DB - PRIME DP - Unbound Medicine ER -