Kumagai Takuya, Miyashita Hitomi, Shimada Uran, Ono Tsuyoshi
Department of Hematology, Nephrology and Rheumatology, Akita University Graduate School of Medicine, Akita, JPN.
Department of Internal Medicine, Municipal Omori Hospital, Yokote, JPN.
Cureus. 2024 Nov 13;16(11):e73589. doi: 10.7759/cureus.73589. eCollection 2024 Nov.
We present a case of a 90-year-old female patient with severe hyponatremia due to syndrome of inappropriate antidiuresis (SIAD) induced by urinary retention. The patient had a history of neurogenic bladder and developed fatigue that progressively worsened over 10 days prior to admission. Initial treatment with hypertonic saline and bladder catheterization led to improvements in her serum sodium levels and symptoms. Based on her clinical course and laboratory findings, urinary retention was determined to be the underlying cause of SIAD. This case highlights that, although rare, urinary retention should be considered a potential trigger for SIAD in patients with unexplained hyponatremia. After relieving urinary retention, suppression of antidiuretic hormone secretion can occur, sometimes leading to rapid correction of serum sodium levels. Therefore, careful monitoring of sodium levels is required to prevent complications such as osmotic demyelination syndrome.
我们报告一例90岁女性患者，因尿潴留诱发抗利尿激素分泌失调综合征（SIAD）导致严重低钠血症。该患者有神经源性膀胱病史，入院前10天出现疲劳，且逐渐加重。最初使用高渗盐水和膀胱插管治疗后，她的血清钠水平及症状有所改善。根据其临床病程和实验室检查结果，确定尿潴留为SIAD的潜在病因。该病例表明，尽管罕见，但对于不明原因低钠血症患者，尿潴留应被视为SIAD的一个潜在触发因素。解除尿潴留后，抗利尿激素分泌可能受到抑制，有时会导致血清钠水平迅速纠正。因此，需要密切监测钠水平，以预防诸如渗透性脱髓鞘综合征等并发症。
