肝转移瘤致肝内胆汁淤积症相关假性低钠血症伴高胆固醇血症：病例报告及文献复习
Pseudohyponatremia Secondary to Hypercholesterolemia in the Setting of Intrahepatic Cholestasis due to Metastatic Liver Disease: A Case Report and Review of the Literature.
机构信息
University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York.
Department of Anesthesiology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA.
出版信息
Acta Med Acad. 2022 Aug;51(2):128-131. doi: 10.5644/ama2006-124.381.
OBJECTIVE
We describe a rare case of pseudohyponatremia in the setting of hypercholesterolemia caused by cholestasis due to metastatic liver disease and provide a review of the published cases in the literature.
CASE REPORT
We report a case of pseudohyponatremia in a 60-year-old man with rectal cancer with extensive metastasis to the liver. While assessing the patient for hyponatremia, extremely elevated serum cholesterol with normal serum osmolality was detected leading to the diagnosis of pseudohyponatremia. This is one of very few reports of pseudohyponatremia in patients with elevated cholesterol in cholestatic liver disease.
CONCLUSION
Hypercholesterolemia is an exceedingly rare cause for pseudohyponatremia. Although pseudohyponatremia per se does not carry a risk to the patient, the delay in diagnosis and treatment plans may pose additional risks. Pseudohyponatremia needs to be considered in patients with low sodium and co-existing cholestasis from metastatic liver disease.
目的
我们描述了一例罕见的由转移性肝疾病引起的胆汁淤积导致的高胆固醇血症继发假性低钠血症，并对文献中已发表的病例进行了回顾。
病例报告
我们报告了一例 60 岁男性直肠癌广泛肝转移患者发生假性低钠血症的病例。在评估该患者低钠血症时，发现其血清胆固醇极度升高，而血清渗透压正常，从而确诊为假性低钠血症。这是为数不多的几例报道的由胆汁淤积性肝病中胆固醇升高引起的假性低钠血症之一。
结论
高胆固醇血症是假性低钠血症极为罕见的病因。虽然假性低钠血症本身对患者没有风险，但诊断和治疗计划的延迟可能会带来额外的风险。对于低钠血症和转移性肝疾病引起的同时性胆汁淤积的患者，需要考虑假性低钠血症。
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