Yoshida Kosuke, Aburakawa Yoko, Suzuki Yasuhiro, Kuroda Kenji, Kimura Takashi
Department of Neurology, National Hospital Organization Asahikawa Medical Center, Japan.
Intern Med. 2019 Jul 1;58(13):1939-1942. doi: 10.2169/internalmedicine.2346-18. Epub 2019 Feb 25.
A 77-year-old woman who had taken a single oral dose of duloxetine subsequently developed a headache and nausea. On the first day, her serum sodium level was 135 mEq/L. She became confused on the third day. Her serum sodium level was 119 mEq/L and her antidiuretic hormone level was 1.9 IU. We diagnosed her with acute hyponatremia from duloxetine-induced syndrome of inappropriate antidiuretic hormone secretion (SIADH). This case suggests that we must not rule out SIADH on the basis of normal serum sodium levels when a patient who has started serotonin-norepinephrine reuptake inhibitor (SNRI) treatment presents with symptoms similar to hyponatremia.
一名77岁女性单次口服度洛西汀后出现头痛和恶心。第一天，她的血清钠水平为135 mEq/L。第三天她变得神志不清。她的血清钠水平为119 mEq/L，抗利尿激素水平为1.9 IU。我们诊断她为度洛西汀诱发的抗利尿激素分泌异常综合征（SIADH）导致的急性低钠血症。该病例提示，当开始使用5-羟色胺-去甲肾上腺素再摄取抑制剂（SNRI）治疗的患者出现类似低钠血症的症状时，我们绝不能基于血清钠水平正常而排除SIADH。
