一名成年红细胞增多症患者的低渗性高钠血症综合征：病例报告

Hypodipsic-hypernatremia syndrome in an adult with polycythemia: a case report.

作者信息

Chothia Mogamat-Yazied, George Kiran, Sheik Muhammed, Davids Mogamat Razeen

机构信息

Division of Nephrology, Department of Medicine, Tygerberg Hospital and Stellenbosch University, Ward A7, Tygerberg Hospital, Francie van Zijl Drive, Parow Valley, Cape Town, 7505, South Africa.

Division of General Medicine, Department of Medicine, Tygerberg Hospital and Stellenbosch University, Cape Town, South Africa.

出版信息

J Med Case Rep. 2018 Dec 27;12(1):381. doi: 10.1186/s13256-018-1938-y.

DOI:10.1186/s13256-018-1938-y

PMID:30587223

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6307108/

Abstract

BACKGROUND

Hypernatremia is a very common electrolyte disorder and is frequently encountered in out-patient as well as in-hospital settings. We describe an adult who was found to have unexplained relative polycythemia and episodic hypernatremia. A diagnosis of idiopathic hypodipsic-hypernatremia syndrome was made and the patient was managed with a water-drinking schedule.

CASE PRESENTATION

A 24-year-old South African-Indian man was found to have polycythemia in association with episodes of hypernatremia. Investigations indicated that he had relative polycythemia. He experienced no thirst at a time when his serum sodium concentration was found to be 151 mmol/L. Further testing indicated that his renal response to arginine vasopressin was intact and magnetic resonance imaging of his brain revealed no hypothalamic lesions. A diagnosis of idiopathic hypodipsic-hypernatremia syndrome was made and he was managed with a water-drinking schedule that corrected his hypernatremia.

CONCLUSION

Hypodipsia should always be considered when a patient without physical or cognitive disability presents with unexplained episodic hypernatremia or with relative polycythemia.

摘要

背景

高钠血症是一种非常常见的电解质紊乱，在门诊和住院环境中都经常遇到。我们描述了一名成年患者，发现其患有不明原因的相对性红细胞增多症和发作性高钠血症。诊断为特发性低渗性高钠血症综合征，并对该患者采用饮水计划进行治疗。

病例介绍

一名24岁的南非印度裔男性被发现患有红细胞增多症并伴有高钠血症发作。检查表明他患有相对性红细胞增多症。当发现他的血清钠浓度为151 mmol/L时，他没有口渴感。进一步检查表明他对精氨酸加压素的肾脏反应正常，脑部磁共振成像显示没有下丘脑病变。诊断为特发性低渗性高钠血症综合征，并通过饮水计划对他进行治疗，纠正了他的高钠血症。