Nakajima Hanako, Okada Hiroshi, Hirose Kazuki, Murakami Toru, Shiotsu Yayoi, Kadono Mayuko, Inoue Mamoru, Hasegawa Goji
Division of Diabetes, Endocrinology, Nephrology and Rheumatology, Japanese Red Cross Kyoto Daini Hospital, Japan.
Intern Med. 2017;56(6):677-680. doi: 10.2169/internalmedicine.56.6843. Epub 2017 Mar 17.
Hyponatremia is a common finding after subarachnoid hemorrhaging (SAH) and can be caused by either cerebral salt-wasting syndrome (CSWS) or syndrome of inappropriate antidiuretic hormone (SIADH). Distinguishing between these two entities can be difficult because they have similar manifestations, including hyponatremia, serum hypo-osmolality, and high urine osmolality. We herein report the case of a 60-year-old man who suffered from SAH complicated by hyponatremia. During his initial hospitalization, he was diagnosed with CSWS. He was readmitted one week later with hyponatremia and was diagnosed with SIADH. This is the first report of SAH causing CSWS followed by SIADH. These two different sources of hyponatremia require different treatments.
低钠血症是蛛网膜下腔出血(SAH)后常见的表现,可由脑性盐耗综合征(CSWS)或抗利尿激素分泌不当综合征(SIADH)引起。区分这两种情况可能很困难,因为它们有相似的表现,包括低钠血症、血清低渗和高尿渗透压。我们在此报告一例60岁男性,患有SAH并伴有低钠血症。在他首次住院期间,被诊断为CSWS。一周后他因低钠血症再次入院,被诊断为SIADH。这是首例SAH先导致CSWS随后又出现SIADH的报告。这两种不同原因导致的低钠血症需要不同的治疗方法。