CASE: We present a case of adenoma malignum in a 52-year-old woman who presented with substantial watery vaginal discharge and profound hyponatremia. [ncbi.nlm.nih.gov]

• Fatigue

  Our patient complained of left knee pain, fatigue, and bilateral lower limb cramps. No pertinent medical history was recorded and her vital signs were within normal limits. [ncbi.nlm.nih.gov]

  Symptoms Hyponatremia can cause fatigue and headaches. Mild hyponatremia may not cause symptoms. [medicalnewstoday.com]

  Cramps may be more associated with neuromuscular fatigue than dehydration/electrolyte losses, and mild dehydration is not associated with increased cramping (3). [diabetesincontrol.com]

• Hypothermia

  However, he returned with hypothermia, hyponatremia, and status epilepticus resulting in intubation. [ncbi.nlm.nih.gov]

  Clinically there is muscle weakness, hypothermia and dehydration. Patient discussion about hyponatremia Q. What steps do you take when your physician says your sodium is low A. [medical-dictionary.thefreedictionary.com]

  This could be due to overdose of certain medications, hypothermia or severe anoxia (lack of oxygen). [en.wikipedia.org]

• Dyspnea

  Eventually, the fluid enters the air spaces in the lungs (pulmonary edema) reduces the amount of oxygen that can enter the blood, and causes shortness of breath (dyspnea) or enters pleural space by transudation (pleural effusion which also causes dyspnea [en.wikipedia.org]

  […] paresteziile si potasium si calciul parestezii = hiperK / hipoCalcemie Pancreatita acuta si calciul Pancreatita acuta --> HIPOcalcemie Hipocalcemie = hipotensiune abdominal pain tetany muscle cramps dyspnea perioral tingling convulsions mental status [quizlet.com]

  Box 2: Applying the results of this review in clinical practice A 60-year-old man presents with increasing dyspnea on exertion. [doi.org]

  He presented with intense dyspnea and cough with greenish expectoration. The only finding of note on physical examination was the presence of disperse rhonchi in both hemithoraxes and the absence of edema or signs of fluid overload. [archbronconeumol.org]

  CASE An 53-year-old woman was seen in an emergency department for evaluating a chest pain and dyspnea for the past two months. [scielo.br]

• Rales

  Signs of hypervolaemia - pulmonary rales, S3 gallop (third heart sound), jugular venous distention, peripheral oedema, ascites. [patient.info]

  […] all-cause mortality and (2) readmission for HF, defined as readmission to the hospital for management of HF (defined by the presence of new symptoms of dyspnea or edema with ≥1 concurrent sign, including ventricular gallop rhythm, bilateral posttussive rales [jamanetwork.com]

• Cheyne-Stokes Respiration

  […] symptoms[edit] Gastro-intestinal[edit] Anorexia Nausea Musculoskeletal[edit] Muscle aches Generalized muscle weakness[3] Neuro-muscular[edit] Myoclonus[3] Decreased reflexes[3] Ataxia[3] Pathological reflexes[3] Tremor[3] Asterixis[3] Respiratory[edit] Cheyne-Stokes [en.wikipedia.org]

• Vomiting

  […] for anyone who develops severe signs and symptoms of hyponatremia, such as nausea and vomiting, confusion, seizures, or lost consciousness. [mayoclinic.com]

  Sometimes the medical history (such as prolonged vomiting or excessive sweating ) will suggest the diagnosis. [rxlist.com]

• Nausea

  […] for anyone who develops severe signs and symptoms of hyponatremia, such as nausea and vomiting, confusion, seizures, or lost consciousness. [mayoclinic.com]

  The patient presented with the following symptoms: nausea, vomiting, diarrhea, and dark urine after drinking large amounts of fluids that included alcohol and caffeine. [ncbi.nlm.nih.gov]

  His small-bowel obstruction, abdominal pain, and nausea resolve. In acute hyponatremia, the serum sodium level drops abruptly over less than 24 hours. The most common causes are nausea, vomiting, and diarrhea. [americannursetoday.com]

  Moreover, nausea and pain which are commonly seen in cancer patients can stimulate ADH hormone production and lead to hyponatremia. [uclahealth.org]

• Loss of Appetite

  A 69-year-old previously well Sinhalese man presented with lethargy, loss of appetite, vomiting, and altered behavior of 1 week's duration. An examination revealed Glasgow Coma Scale of 13/15 and marginally low blood pressure. [ncbi.nlm.nih.gov]

  They include: headache nausea, loss of appetite, vomiting malaise lethargy weakness poor coordination muscle cramps somnolence disorientation personality change Physical Exam Volume status assessment is important to determine cause. [sharinginhealth.ca]

  Symptoms like nausea, vomiting, loss of appetite, headaches, weakness, fatigue and confusion characterize hyponatremia. Complications in severe cases can include brain damage due to swelling; falls; seizures and coma. [draxe.com]

  Possible confounding factors are a low dietary intake of potassium (loss of appetite is common in adrenal insufficiency) and loss of potassium through vomiting. [academic.oup.com]

  confusion, lethargy, fatigue, loss of appetite, irritability, muscle weakness, spasms or cramps, seizures, and decreased consciousness or coma.[11] Lower levels of plasma sodium are associated with more severe symptoms. [en.wikipedia.org]

• Hiccup

  […] treatment of schizophrenia, bipolar disorder and other affective psychoses, but also in other neuropsychiatric disorders (such as dementia and autism), symptomatic treatment of acute confusional symptoms and other conditions not psychiatric (nausea, hiccups [intechopen.com]

• Hypotension

  After several weeks of suffering from gastroenteritis with vomiting, she presented with disturbance of consciousness, hypotension, dehydration, and severe hyponatremia (108 mEq/L) and a markedly increased serum vasopressin concentration (45.5 pg/mL). [ncbi.nlm.nih.gov]

  Hypovolemia or Hypotension: For patients who develop hypovolemia or hypotension while receiving VAPRISOL, VAPRISOL should be discontinued, and volume status and vital signs should be monitored. [vaprisol.com]

  Udgivelsesdato: 2008-Dec-8 AB - Acute adrenal insufficiency is a life threatening disease with dehydration, hypotension, cerebral dysfunction and gastrointestinal symptoms accompanied by low plasma sodium and high plasma potassium. [pure.au.dk]

• Orthostatic Hypotension

  Patients presenting with orthostatic hypotension and normal plasma sodium concentrations are frequently admitted to the hospital with a diagnosis of dehydration. [doi.org]

  同时专家们还提出了两个新概念，我觉得也很有意思： 起始体位性低血压（initial orthostatic hypotension） Initial orthostatic hypotension is defined as a transient blood pressure decrease (40 mmHg systolic blood pressure and/or 20 mmHg diastolic blood pressure) within 15 s of standing. [news.medlive.cn]

  ADVERSE REACTIONS The most common adverse reactions (incidence ≥10%) reported in clinical trials were infusion site reactions (including phlebitis), pyrexia, hypokalemia, headache and orthostatic hypotension. [vaprisol.com]

  POINTS TO REMEMBER Primary adrenal insufficiency can present without pigmentation, orthostatic hypotension, hyperkalemia, hypoglycaemia, and hypercalcemia. [academic.oup.com]

• Jugular Venous Distention

  Signs of hypervolaemia - pulmonary rales, S3 gallop (third heart sound), jugular venous distention, peripheral oedema, ascites. [patient.info]

  venous distention, edema), elevated B-type natriuretic peptide level, echocardiography, urinary sodium < 20 mEq per L Diuretics, angiotensin-converting enzyme inhibitors, beta blockers Hepatic failure/cirrhosis Elevated liver function tests, ascites, [aafp.org]

• Muscle Cramp

  And contrary to popular belief, muscle cramps and fatigue aren't caused by dehydration but from pushing too hard. If an athlete starts to experience these symptoms, he should be allowed to sit it out for a few minutes. [mnn.com]

  Anthropomorphic characteristics, exercise time, and post-exercise ratings of thermal sensation, perceived exertion and muscle cramp were similar for LC, AM and CON. [ncbi.nlm.nih.gov]

  […] hy·po·na·tre·mia | \ ˌhī-pō-nā-ˈtrē-mē-ə \ variants: or chiefly British hyponatraemia medical : the condition of having an abnormally low level of sodium in the blood that is typically marked by nausea, vomiting, headache, confusion, fatigue, and muscle [merriam-webster.com]

• Muscle Weakness

  A 52-year-old Sri Lankan man presented with anorexia, nausea, fatigue, generalized muscle weakness, and cramps for 1 week. The onset of his illness had been preceded by vomiting and diarrhea for 1 day which he attributed to food poisoning. [ncbi.nlm.nih.gov]

  Other symptoms include: Fatigue Convulsions Headache Muscle weakness or spasms Nausea and vomiting Restlessness Confusion Decreased consciousness Treatment of Hyponatremia Under no circumstances should the individual be given hypotonic or isotonic fluids [sportsinjuryclinic.net]

  Sodium is an electrolyte that helps the regulation of body fluids, therefore in electrolyte imbalances like hyponatremia lead to signs and symptoms of headache, confusion, loss of energy, muscle weakness, coma, and even seizures! [youtube.com]

  Muscle weakness. Poor appetite that does not improve. Shortness of breath, chest pain or discomfort; should be evaluated immediately. [chemocare.com]

• Muscle Hypotonia

  Motor delays and waddling gait have been attributed to muscle hypotonia. In severe cases, impaired hearing can develop over time. [biodonsys.com]

• Seizure

  PURPOSE: To evaluate the safety of eslicarbazepine acetate (ESL) in new onset elderly poststroke seizure patients, especially with respect to hyponatremia. [ncbi.nlm.nih.gov]

  Answer and interpretation Exercise-associated hyponatremia (EAH) complicated by encephalopathy (confusion and seizure). There is also evidence of seizure-induced or exercise-induced rhabdomyolysis and mild renal impairment. [lifeinthefastlane.com]

  Therefore, medical care should be sought when individuals develop altered mental status, confusion, or lethargy; have had a seizure ; or cannot be wakened. [emedicinehealth.com]

• Confusion

  Cognitive impairment (eg, short-term memory loss, disorientation, confusion, depression). Focal or generalised seizures. [patient.info]

  A 41 year old Jordanian gentleman known case of osteogenesis imperfecta presented with vomiting, decreased oral intake followed by confusion. At presentation he was found to have signs of hypogonadism with severe hyponatremia. [ncbi.nlm.nih.gov]

  In more serious instances, the brain swells, and confusion and dementia can set it as it presses against the skull. [health.howstuffworks.com]

• Headache

  METHODS: An 8-y boy presented with headache, vomiting, and diplopia. Magnetic resonance imaging of the brain confirmed a mass in the pineal region. Pathology report demonstrated a mixed germ cell tumor with a yolk sac component. [ncbi.nlm.nih.gov]

  When he complains of a headache, she administers acetaminophen 650 mg, as ordered. Two hours later, he reports his headache is worse. He seems irritable and has a hard time remembering where he is and why he’s in the hospital. [americannursetoday.com]

  You may take medications to manage the signs and symptoms of hyponatremia, such as headaches, nausea and seizures. [mayoclinic.org]

• Lethargy

  Thirteen months later, he was hospitalized for lethargy and hyponatremia of 108 mEq/L, with an antidiuretic hormone level of 2.5 pg/mL, which suggested syndrome of inappropriate antidiuretic hormone secretion (SIADH). [ncbi.nlm.nih.gov]

  Therefore, medical care should be sought when individuals develop altered mental status, confusion, or lethargy; have had a seizure ; or cannot be wakened. [emedicinehealth.com]

• Altered Mental Status

  Her serum [Na] and altered mental status corrected slowly over the next 48 hours with furosemide, hypertonic saline, and fluid restriction. [ncbi.nlm.nih.gov]

  Less common but still belonging in the differential are pseudohyponatremia secondary to alcohol-induced severe hypertriglyceridemia and cerebral salt wasting syndrome. 2,3 Beer potomania usually manifests as altered mental status, weakness, and gait disturbance [mdedge.com]

  Therefore, medical care should be sought when individuals develop altered mental status, confusion, or lethargy; have had a seizure ; or cannot be wakened. [emedicinehealth.com]

Yield of performed workup for hypothyroidism and hypoadrenalism in euvolemic hyponatremia was low. [ncbi.nlm.nih.gov]

After a thorough workup, he was diagnosed to have reset osmostat. Reset osmostat is an uncommon and under recognised cause of hyponatremia which does not require any treatment. [hindawi.com]

Simon EE, Hamrahian SM, Teran FJ.Hyponatremia workup. http://emedicine.medscape.com/article/242166-workup#a0719. Accessed December 10, 2013. 37. Agrawal V, Agarwal M, Joshi SR, Ghosh AK. Hyponatremia and hypernatremia: disorders of water balance. [journals.lww.com]

That diagnostic workup is important because isotonic (0.9%) saline therapy is ineffective for treating hyponatremia associated with SIADH, as the 2013 expert panel recommendations note. [acphospitalist.org]

Copeptin in hyponatremia: is there a role for this biomarker in the diagnostic workup?. Endocrine. 2018 Jun. 60 (3):384-5. [Medline]. [Full Text]. Lindner G, Schwarz C. An update on the current management of hyponatremia. [emedicine.com]

• Urine Sodium Decreased

  Additionally, urine osmolality increased from 365 mOsm/kg (IQR, 361–561) to 546 mOsm/kg (IQR, 542–602; P=0.13), whereas urine sodium decreased from 75 mEq/L (IQR, 42–105) to 50 mEq/L (IQR, 37–76; P=0.06). [cjasn.asnjournals.org]

Current HN treatment varies widely, with no consensus. This study recorded treatment practices currently used for patients hospitalized with acute heart failure and HN. [ncbi.nlm.nih.gov]

In general, this neurological disorder has a fatal prognosis. We observed a 30-year-old woman with a history of chronic alcohol abuse but without evidence of hyponatremia, who developed severe pontine central myelinolysis. [ncbi.nlm.nih.gov]

Conclusions We demonstrated that hyponatremia was significantly associated with poorer prognosis in SCLC regardless of extensive or limited stage. The value of hyponatremia in SCLC is as a candidate prognosis factor in clinical practice. [tcr.amegroups.com]

The most common etiology of hypopituitarism was non-functioning pituitary macro adenoma (NFPA) (n = 128, 49.2%). [ncbi.nlm.nih.gov]

This review focuses on the epidemiology, pathogenesis, and therapy of exercise-associated hyponatremia. [ncbi.nlm.nih.gov]

The AVP activity combines with other dilutional pathophysiologies to result in hyponatremia. Pathophysiology of hyponatremia in cirrhosis 3 Multiple factors lead to the development of hyponatremia in cirrhotic patients. [vaprisol.com]

Because age-related changes and chronic diseases are often associated with impairment of water metabolism in elderly patients, it is absolutely essential for clinicians to be aware of the pathophysiology of hyponatremia and hypernatremia in the elderly [ncbi.nlm.nih.gov]

Exploration of the development of new drugs that can effectively resolve the pathophysiology of systemic vasodilation in patients with cirrhosis is an additional avenue for study. [aasldpubs.onlinelibrary.wiley.com]

The precise pathophysiology is mostly unknown. [revportcardiol.org]

Abstract Symptomatic exercise-associated hyponatremia (EAH) is known to be a potential complication from overhydration during exercise, but there remains a general belief that sodium supplementation will prevent EAH. [ncbi.nlm.nih.gov]

While relatively less probable to occur compared to dehydration, prevention is key to avoid hyponatremia related illness. Hyponatremia FAQs How do you prevent hyponatremia? Know thyself. [guenergy.com]