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مثال
Sodium (Na+), serum
specimen: serum
ref. range: 135-148 mmol/L
Decreased sodium – hyponatraemia
Values in the range 130-134 are common and sometimes difficult to explain. Below
130, an explanation must be sought.
• fluid or electrolyte loss with inadequate electrolyte replacement –
diarrhoea, vomiting, excessive sweating, post-operative losses, fistulae,
parenteral fluid replacement with saline <0.9%.
• drugs – diuretics (particularly thiazides), ACE inhibitors, NSAIDs,
carbamazepine, imipramine, amitriptyline, lithium, – and others
• oedematous states – cardiac, hepatic, renal
• renal tubular disease – salt-losing syndromes
• Legionnaire’s disease and other chest infections
• pseudo-hyponatraemia – hyperlipidaemias and paraproteinaemias
• endocrine diseases — diabetes, hypothyroidism, Addison’s disease,
hypopituitarism
SIADH – syndrome of inappropriate ADH, a common cause of hyponatraemia,
including those where the sodium is very low (<125). Causes of SIADH include:
– carcinoma, particularly of lung
– pulmonary infections
– CNS disorders
– drugs
The cause of the low serum sodium is water retention due to inappropriate secretion
of ADH in the face of a serum osmolality below 270 mosmol/L
مثال
Sodium (Na+), serum
specimen: serum
ref. range: 135-148 mmol/L
Decreased sodium – hyponatraemia
Values in the range 130-134 are common and sometimes difficult to explain. Below
130, an explanation must be sought.
• fluid or electrolyte loss with inadequate electrolyte replacement –
diarrhoea, vomiting, excessive sweating, post-operative losses, fistulae,
parenteral fluid replacement with saline <0.9%.
• drugs – diuretics (particularly thiazides), ACE inhibitors, NSAIDs,
carbamazepine, imipramine, amitriptyline, lithium, – and others
• oedematous states – cardiac, hepatic, renal
• renal tubular disease – salt-losing syndromes
• Legionnaire’s disease and other chest infections
• pseudo-hyponatraemia – hyperlipidaemias and paraproteinaemias
• endocrine diseases — diabetes, hypothyroidism, Addison’s disease,
hypopituitarism
SIADH – syndrome of inappropriate ADH, a common cause of hyponatraemia,
including those where the sodium is very low (<125). Causes of SIADH include:
– carcinoma, particularly of lung
– pulmonary infections
– CNS disorders
– drugs
The cause of the low serum sodium is water retention due to inappropriate secretion
of ADH in the face of a serum osmolality below 270 mosmol/L
تعليق