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The causes of hyponatremia vary greatly from medication-induced to dehydration, and the treatment is dependent on the cause. In our patient, the believed physiologic cause was an inappropriate secretion of antidiuretic hormone or SIADH. Laboratory studies often show a high urine sodium and a low serum uric acid. While the etiology ranges from central nervous system (CNS) disturbances to infections, one often seen offender includes medications.

Typical causes include thiazides, antipsychotics, non-steroidal anti-inflammatories, and antidepressants. Our patient was notable for not being on any medications known to commonly cause hyponatremia. Rarely, the use of ACE inhibitors in various settings has been linked to SIADH-related hyponatremia. To date, there have been less than 25 published case reports of ACE inhibitor-related hyponatremia when searched on Drug slang. Of these, the duration of ACE inhibitor use varied significantly, ranging from new drug slang to chronic medications.

Patients also frequently had various inciting events that complicated the picture. However, few, if any, of the events were typical causative factors for Drug slang hyponatremia. Implicated ACE inhibitors included enalapril, lisinopril, captopril, ramipril, and cilazapril.

The drug slang chronicity of medication use in some cases seems drug slang suggest drug slang mechanism more nuanced and indirect than a direct effect of ACE inhibitors on antidiuretic hormone production.

The variations in chemical makeup of different ACE inhibitors may impact their ability drug slang affect the endogenous CNS RAS and thereby produce different degrees of effect, i. It should be noted that this is a hypothesis that likely requires further research at the pharmacokinetic level. As noted above, many of the reported cases appeared to have an inciting event lending credibility to the theory that a variability in CNS inhibition of angiotensin I conversion due to Drug slang inhibitors may alter or lower the threshold at which new events trigger SIADH and subsequent hyponatremia.

In general, the outcome remains positive. As noted in our patient, the cessation of lisinopril and fluid restriction led to the correction of drug slang levels which remained normal on follow-up. While it should be acknowledged that chronic alcoholism can cause drug slang, our patient's alcohol use continued without an adverse effect on his serum sodium level. This report contributes to the body of literature that further elucidates a rare, but dangerous complication associated with a frequently prescribed medication.

As with prior reports, we cannot concretely conclude the reason behind ACE inhibitor-associated SIADH and hyponatremia. However, given the number of similar reports and the dangers of severe hyponatremia, clinicians should be aware of the potential for hyponatremia in patients on lisinopril or other ACE inhibitor therapy, especially in an inpatient setting when critical illness may further lower the threshold to trigger SIADH. Human subjects: Consent was obtained by all participants drug slang this study.

Financial relationships: All authors have declared that they have no financial relationships at drug slang or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced how to commit suicide submitted work.

Jiang Y, Cai W, Masquelin M E, et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4. This is an open access andre la roche distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Comments:

21.05.2019 in 12:51 wagjimiba93:
Это хорошо когда так!

21.05.2019 in 22:12 Алевтина:
Извините за то, что вмешиваюсь… Я здесь недавно. Но мне очень близка эта тема. Готов помочь.

22.05.2019 in 14:34 Ксения:
Обмен ссылкой эту копирую