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一位超高龄患者应用度洛西汀致抗利尿激素不适当分泌综合征。

Duloxetine-induced Syndrome of Inappropriate Secretion of Antidiuretic Hormone in a Super-elderly Patient.

机构信息

Department of Internal Medicine, National Health Insurance Kuma-Kogen Town Hospital, Japan.

Health Services Center, Ehime University, Japan.

出版信息

Intern Med. 2022 Apr 1;61(7):1099-1103. doi: 10.2169/internalmedicine.7722-21. Epub 2021 Sep 11.

Abstract

Duloxetine is widely used for pain control and depressive syndromes. One of its potential side effects is syndrome of inappropriate secretion of antidiuretic hormone (SIADH). Duloxetine-induced SIADH causes hyponatremia, which leads to a variety of symptoms and has previously been reported in the elderly. In the present case, we experienced a case of the rapid onset of SIADH in a super-elderly woman receiving low-dose duloxetine. Elderly patients tend to have lower duloxetine doses and an earlier onset than non-elderly patients. When hyponatremia occurs after duloxetine administration, duloxetine-induced SIADH should be considered, especially in high-risk elderly patients, regardless of the duloxetine dose or duration of treatment.

摘要

度洛西汀被广泛用于疼痛控制和抑郁综合征。其潜在的副作用之一是抗利尿激素分泌不当综合征(SIADH)。度洛西汀引起的 SIADH 导致低钠血症,导致各种症状,此前已有报道见于老年人。在本病例中,我们在接受低剂量度洛西汀治疗的超高龄女性中遇到了一例 SIADH 快速发作的病例。老年患者的度洛西汀剂量往往低于非老年患者,且发病更早。当度洛西汀给药后出现低钠血症时,应考虑度洛西汀引起的 SIADH,尤其是高危老年患者,无论度洛西汀剂量或治疗持续时间如何。

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