Abstract:
:We report a case of a 50-year-old malnourished African American male with hiccups, nausea and vomiting who was brought to the Emergency Department after repeated seizures at home. Laboratory evaluations revealed sodium (Na(+)) 107 mmol/L, unmeasurably low potassium, chloride < 60 mmol/L, bicarbonate of 38 mmol/L and serum osmolality 217 mOsm/kg. Seizures were controlled with 3% saline IV. Once nausea was controlled with iv antiemetics, he developed large volume free water diuresis with 6 L of dilute urine in 8 h (urine osmolality 40-60 mOsm/kg) and serum sodium rapidly rose to 126 mmol/L in 12 h. Both intravenous desmopressin and 5% dextrose in water was given to achieve a concentrated urine and to temporarily reverse the acute rise of sodium, respectively. Serum Na(+) was gradually re-corrected in 2-3 mmol/L daily increments from 118 mmol/L until 130 mmol/L. Hypokalemia was slowly corrected with resultant auto-correction of metabolic alkalosis. The patient discharged home with no neurologic sequaele on the 11(th) hospital day. In euvolemic hyponatremic patients, controlling nausea may contribute to unpredictable free water diuresis. The addition of an antidiuretic hormone analog, such as desmopressin can limit urine output and prevent an unpredictable rise of the serum sodium.
journal_name
World J Clin Casesjournal_title
World journal of clinical casesauthors
Gharaibeh KA,Craig MJ,Koch CA,Lerant AA,Fülöp T,Csongrádi Edoi
10.12998/wjcc.v1.i5.155subject
Has Abstractpub_date
2013-08-16 00:00:00pages
155-8issue
5issn
2307-8960journal_volume
1pub_type
abstract:BACKGROUND:Underwater endoscopic mucosal resection (UEMR) of colorectal lesions is emerging as an alternative method to conventional endoscopic mucosal resection (EMR); however, it is still controversial whether there is a difference in the effectiveness between UEMR and EMR. AIM:To evaluate the effectiveness and safe...
journal_title:World journal of clinical cases
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journal_title:World journal of clinical cases
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abstract:BACKGROUND:The most important factors affecting the decision of organ donation are socioeconomic, educational, cultural, and religious factors. AIM:To evaluate Islamic religious officials' attitudes and behaviors toward and level of knowledge on organ donation and transplantation. METHODS:This study surveyed 2350 Isl...
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journal_title:World journal of clinical cases
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journal_title:World journal of clinical cases
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journal_title:World journal of clinical cases
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journal_title:World journal of clinical cases
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journal_title:World journal of clinical cases
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journal_title:World journal of clinical cases
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journal_title:World journal of clinical cases
pub_type: 杂志文章
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更新日期:2019-09-26 00:00:00
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journal_title:World journal of clinical cases
pub_type:
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更新日期:2020-01-26 00:00:00
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journal_title:World journal of clinical cases
pub_type:
doi:10.12998/wjcc.v8.i23.6095
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journal_title:World journal of clinical cases
pub_type: 杂志文章
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更新日期:2020-11-06 00:00:00
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journal_title:World journal of clinical cases
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journal_title:World journal of clinical cases
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journal_title:World journal of clinical cases
pub_type:
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journal_title:World journal of clinical cases
pub_type: 杂志文章
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journal_title:World journal of clinical cases
pub_type: 杂志文章
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journal_title:World journal of clinical cases
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journal_title:World journal of clinical cases
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journal_title:World journal of clinical cases
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journal_title:World journal of clinical cases
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journal_title:World journal of clinical cases
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