Liberopoulos Evagelos N, Alexandridis George H, Christidis Dimitris S, Elisaf Moses S
Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece.
Ann Pharmacother. 2002 Jul-Aug;36(7-8):1180-2. doi: 10.1345/aph.1A425.
To report a case of possible theophylline-induced hyponatremia due to the syndrome of inappropriate antidiuretic hormone (SIADH).
An 88-year-old man developed severe symptomatic hyponatremia (serum sodium 112 mEq/L) associated with inappropriate natriuresis (urinary sodium 58 mEq/L) temporally related to the initiation of theophylline. The patient fulfilled the criteria for the diagnosis of SIADH after all other causes of hyponatremia were excluded. Furthermore, no other drugs or conditions that could have evoked SIADH were found.
Theophylline has rarely been associated with hyponatremia. A thiazide-like action of the drug on the stimulation of SIADH could be the underlying mechanism for SIADH.
Theophylline should be considered as a possible cause of hyponatremia.
报告一例可能因抗利尿激素分泌异常综合征(SIADH)导致的茶碱诱发低钠血症病例。
一名88岁男性出现严重的症状性低钠血症(血清钠112 mEq/L),伴有不适当的尿钠排泄(尿钠58 mEq/L),时间上与开始使用茶碱有关。在排除所有其他低钠血症原因后,该患者符合SIADH的诊断标准。此外,未发现其他可诱发SIADH的药物或情况。
茶碱很少与低钠血症相关。该药物对SIADH刺激的类噻嗪样作用可能是SIADH的潜在机制。
应将茶碱视为低钠血症的可能原因。