McCoin Nicole, Marcum Samuel, Martin Julia
Vice Dean for Faculty Affairs and Development; Professor, Department of Emergency Medicine, University of Kentucky College of Medicine, William R Willard Medical Education Building, MN 140, Lexington, KY 40536, United States of America.
PGY-2, Department of Emergency Medicine, University of Kentucky College of Medicine, 780 Rose Street, Room M53, Lexington, KY 40536, United States of America.
Am J Emerg Med. 2025 Jul;93:236.e1-236.e2. doi: 10.1016/j.ajem.2025.03.063. Epub 2025 Apr 1.
Hyponatremia is common in hospitalized patients. Syndrome of inappropriate antidiuresis (SIAD) is a known cause of hyponatremia, with many different causes. Normal pressure hydrocephalus-related SIAD with resultant hyponatremia is a less known association. This case report is of a 77-year-old male with known normal pressure hydrocephalus (NPH) presenting with acute mental status changes and severe hyponatremia and found to have SIAD due to his NPH. A lumbar puncture quickly improved both his confusion and hyponatremia. The association between SAID and NPH is important as the management may require a lumbar puncture to improve symptoms. Emergency physicians must know this association to help make correct diagnoses and guide treatment.
低钠血症在住院患者中很常见。抗利尿激素分泌失调综合征（SIAD）是低钠血症的一个已知病因，有许多不同的成因。与正常压力脑积水相关的SIAD及其导致的低钠血症是一种鲜为人知的关联。本病例报告的是一名77岁男性，已知患有正常压力脑积水（NPH），出现急性精神状态改变和严重低钠血症，经检查发现其低钠血症是由NPH所致的SIAD引起。一次腰椎穿刺迅速改善了他的意识模糊和低钠血症症状。SIAD与NPH之间的关联很重要，因为其治疗可能需要进行腰椎穿刺以改善症状。急诊医生必须了解这种关联，以帮助做出正确诊断并指导治疗。
