Neurological Counterparts of Hyponatremia: Pathological Mechanisms and Clinical Manifestations

Podestà, Manuel Alfredo; Faravelli, Irene; Cucchiari, David; Reggiani, Francesco; Oldani, Sabina; Fedeli, Carlo; Graziani, G.

doi:10.1007/s11910-015-0536-2

Cited by 21 publications

(20 citation statements)

References 62 publications

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“…The mechanism seems to be cytotoxicity affecting para ventricular and supraoptic neurons [38] other reports showed that the reason for sodium low [39] the result also showed that the sodium levels were decreased with age and this was in agreement with other reports.…”

Section: -Sodiumsupporting

confidence: 91%

Studying of Metal Elements in Cerebrospinal Fluid for Children With Acute Lymphoblastic Leukemia Patients

Bdaiwi¹

2017

WJPPS

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The research includes studying the levels of some metal elements and electrolyte in the cerebrospinal fluid (CSF) for acute lymphoblastic leukemia ALL patients these parameters include: Iron (Fe), Cupper (Cu), Zinc(Zn), Magnesium (Mg), Sodium (Na), Potassium (K), Calcium (Ca), Phosphorus (P) and Chloride (Cl) levels in CSF. The study was done on (140) sample (95) were male and(45) female and (73) were healthy children as healthy group(39) male and (34) female the age of children with acute lymphoblastic leukemia ranged from 1-15 years for both sex. The results showed there was a significant increase in Fe, Cu, K, and P in the CSF for children with acute lymphoblastic leukemia patients in comparison with control group for both sex, and all age group a significant decrease was shown in the levels of Zn, Mg, Ca and Na. while there was non-significant decrease in Cl levels.

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Section: -Sodiumsupporting

confidence: 91%

Studying of Metal Elements in Cerebrospinal Fluid for Children With Acute Lymphoblastic Leukemia Patients

Bdaiwi¹

2017

WJPPS

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“…Because the brain is confined by the rigid skull, tissue expansion compresses blood vessels to cause deficits in cerebral circulation, and eventually leads to herniation of the brainstem. Milder reductions in blood Na + levels produce a variety of neurological symptoms – such as nausea, confusion, headaches, and hallucinations – and elevate the risk of death in co-morbid states [67, 162, 204]. …”

Section: Common and Unique Roles Of Vrac Within The Brainmentioning

confidence: 99%

Volume-regulated anion channel—a frenemy within the brain

Mongin

2015

Pflugers Arch - Eur J Physiol

115

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Volume regulated anion channel (VRAC) is a ubiquitously expressed yet highly enigmatic member of the superfamily of chloride/anion channels. It is activated by cellular swelling and mediates regulatory cell volume decrease in a majority of vertebrate cells, including those in the central nervous system (CNS). In the brain, besides its crucial role in cellular volume regulation, VRAC is thought to play a part in cell proliferation, apoptosis, migration, and release of physiologically active molecules. Although these roles are not exclusive to the CNS, the relative significance of VRAC in the brain is amplified by several unique aspects of its physiology. One important example is contribution of VRAC to release of the excitatory amino acid neurotransmitters, glutamate and aspartate. This latter process is thought to have impact on both normal brain functioning (such as astrocyte-neuron signaling) and neuropathology (via promoting the excitotoxic death of neuronal cells in stroke and traumatic brain injury). In spite of much work in the field the molecular nature of VRAC remained unknown until less than two years ago. Two pioneer publications identified VRAC as the hetero-hexamer formed by the leucine-rich repeat-containing 8 (LRRC8) proteins. These findings galvanized the field and are likely to result in dramatic revisions to our understanding of the place and role of VRAC in the brain, as well as other organs and tissues. The present review briefly recapitulates critical findings in the CNS, and focuses on anticipated impact on the LRRC8 discovery on further progress in neuroscience research.

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“…Even small decreases of serum sodium are associated with increased probability for adverse outcomes (cognitive impairment, falls, osteoporosis and fractures) [3].Decreased serum sodium levels are occasionally observed in patients with diabetes mellitus and can be attributed to numerous underlying pathogenetic mechanisms (Table 1) [4,5].The direct measurement of serum osmolality (Posm) can differentiate between hypotonic hyponatremia (with decreased Posm) and hyponatremia associated with normal or even increased tonicity. In the latter case hyponatremia is usually due to the coexistent hyperglycemia [6].…”

mentioning

confidence: 99%

“…Even small decreases of serum sodium are associated with increased probability for adverse outcomes (cognitive impairment, falls, osteoporosis and fractures) [3].…”

mentioning

confidence: 99%

Hyponatremia in Diabetes Mellitus: Clues to Diagnosis and Treatment

Vasilios¹

2015

J Diabetes Metab

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Hyponatremia is the most common electrolyte abnormality in clinical practice and is associated with increased morbidity and mortality [1,2]. Even small decreases of serum sodium are associated with increased probability for adverse outcomes (cognitive impairment, falls, osteoporosis and fractures) [3].Decreased serum sodium levels are occasionally observed in patients with diabetes mellitus and can be attributed to numerous underlying pathogenetic mechanisms (Table 1) [4,5].The direct measurement of serum osmolality (Posm) can differentiate between hypotonic hyponatremia (with decreased Posm) and hyponatremia associated with normal or even increased tonicity. In the latter case hyponatremia is usually due to the coexistent hyperglycemia [6]. In fact, glucose is an osmotic active substance. Thus, in cases of marked hyperglycemia Posm is increased leading to movement of water out of cells and subsequently to a reduction of serum sodium levels (dilutional hyponatremia). In such cases the corrected, for the degree of hyperglycemia, serum sodium value should be calculated. Thus, to obtain the "true" sodium level in cases of extreme hyperglycemia, the addition of 2.4 mEq/L to the measured concentration for every 100 mg/dl increment in plasma glucose above normal levels is required [7]. This corrected serum sodium level should be used during treatment of severe hyperglycemic states [8]. In patients with dilutional hyponatremia the treatment of hyperglycemia is usually followed by a normalization of serum sodium levels [4].No hypotonic hyponatremia (with a normal measured Posm) can also be due to pseudohyponatremia associated with hyperglycemiainduced severe hypertriglyceridemia and perhaps hypovolemiainduced hyperproteinemia. It is well known that when the proportion of a serum sample occupied by substances other than water and electrolytes (such as lipids and proteins) exceeds the usual value of 7%, serum sodium levels measured by ion-selective electrodes using the indirect method are falsely lower than true values [9][10][11][12][13]. Thus, in patients with lipemic serum and severe hypertriglyceridemia, sodium levels should be measured by direct potentiometry in blood gas panels. This method does not include a predilution step and is not susceptible to the aforementioned errors [13]. Diagnosis of pseudohyponatremia is necessary to avoid dangerous overtreatment. It should be mentioned that pseudohyponatremia does not produce any of the symptoms classically attributed to hyponatremia. Improvement in glycemic control is associated with a rapid decrease in serum triglycerides resulting in the correction of pseudohyponatremia. Thus, no specific treatment is required [4,6].The most common cause of hypotonic hyponatremia in patients with diabetes is osmotic diuresis-induced hypovolemia [4]. It should be mentioned that in patients with diabetic ketoacidosis the excretion of β-hydroxybutyrate and acetoacetate obligate urine sodium losses resulting in aggravation of hypovolemia [14]. Hypovolemia can also be due to diabetes mel...

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Neurological Counterparts of Hyponatremia: Pathological Mechanisms and Clinical Manifestations

Cited by 21 publications

References 62 publications

Studying of Metal Elements in Cerebrospinal Fluid for Children With Acute Lymphoblastic Leukemia Patients

Studying of Metal Elements in Cerebrospinal Fluid for Children With Acute Lymphoblastic Leukemia Patients

Volume-regulated anion channel—a frenemy within the brain

Hyponatremia in Diabetes Mellitus: Clues to Diagnosis and Treatment

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