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    Please use this identifier to cite or link to this item: https://ir.fy.edu.tw:8080/ir/handle/987654321/9523


    Title: Water Restriction and Loop Diuretics Cause Osmotic Demyelination Syndrome in a Patient with Syndrome of Inappropriate Antidiuretic Hormone Secretion.
    Authors: Chiou-An Chen;Weng-Sheng Tsai;Cheng-Yu Chen;Shih-Hua Lin
    Contributors: 輔英科技大學 物理治療系
    Keywords: hyponatremia;loop diuretics;osmotic demyelination syndrome;syndrome of inappropriate secretion of antidiuretic hormone (SIADH);water restriction
    Date: 2004-08-01
    Issue Date: 2010-11-10 09:42:44 (UTC+8)
    Abstract: Osmotic demyelination syndrome following the rapid correction of chronic hyponatremia with combined water restriction
    and the administration of loop diuretics is the least known complication of chronic hyponatremia. We describe a 28-year-old
    woman who had complained of generalized weakness, anorexia, nausea, and dizziness for 3 days. The most striking
    biochemical abnormality was hyponatremia (Na+ 117 mmol/l). This hyponatremia met the laboratory diagnostic criterion for
    the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). Treatment with 2 liters of normal saline for 2 days
    did not correct her hyponatremia. Therefore, she was treated with water restriction together and furosemide (40 mg per day).
    Polyuria and a body weight loss of 5 kg ensued, and her plasma Na+ concentration rose from 119 to 132 mmol/l within 24
    h. Acute delirium, Wernicke’s aphasia, and parkinsonism developed 2 days later. Magnetic resonance imaging of the brain
    clearly showed typical features of extrapontine myelinolysis. Subsequent neurological and radiological features indicated
    various lesions of brain insult. We suggest that water restriction combined with the administration of loop diuretics might
    cause rapid correction of hyponatremia in some patients with SIADH. Calculation of the tonicity balance and close monitoring
    of serum and urine electrolytes are critical if osmotic demyelination syndrome is to be avoided during the correction of chronic
    hyponatremia.
    Relation: J Med Sci 24(4),231-236
    Appears in Collections:[物理治療系] 期刊論文

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