Three Cases of Mineralocorticoid-responsive Hyponatremia of the Elderly

Nakamura, Sachiko; Iida, Keiji; Tamagawa, Anna; Hino, Yasuhisa; Oohara, Takesi; Takahashi, Yoshiko; Takahashi, Naoto; Chihara, Kazuo

doi:10.2169/naika.103.1382

Cited by 2 publications

(3 citation statements)

References 3 publications

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“…6,7 Mild dehydration, recovery with salt supplementation, elimination of other possible causes or effectiveness of fludrocortisone support the diagnosis 8 although remission without fludrocortisone is possible in MRHE-like dysfunctions. 9,10 In the present case, besides the examination data, recovery with enough sodium and fluid supplementation, but without water restriction and no detection of apparent other possible causes, were compatible with MRHE. Mild dehydration might have been present, but was possibly masked by water loading, as more water retention occurs in MRHE 6 Acute water intoxication was implied to relate to aging.…”

Section: Dear Editorsupporting

confidence: 66%

Acute water intoxication in an older woman despite a relatively small amount of water loading

Sato

Hayashi

Mikada

et al. 2018

Geriatrics Gerontology Int

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Section: Dear Editorsupporting

confidence: 66%

Acute water intoxication in an older woman despite a relatively small amount of water loading

Sato

Hayashi

Mikada

et al. 2018

Geriatrics Gerontology Int

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“…However, random cortisol level was ≤15.2 μg/dL in at least 4 cases, suggesting the possibility of adrenal insufficiency. [5,7,9,10] Low-dose ACTH stimulation test was not employed to rule out relative adrenal dysfunction. Fludrocortisone acetate 0.02 to 0.4 mg/day was administered in 20 cases and hyponatremia improved in 2 weeks.…”

Section: Resultsmentioning

confidence: 99%

“…[20] For these reasons, the possibility of adrenal insufficiency might not have been ruled out in at least 4 cases in our current review. [5,7,9,10] In addition, cases with recent use of diuretic agent and correction of hyponatremia without the use of fludrocortisone acetate might need to be excluded.…”

Section: Discussionmentioning

confidence: 99%

Mineralocorticoid responsive hyponatremia of the elderly

Katayama

Tokuda²

2017

Medicine

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Background:Mineralocorticoid responsive hyponatremia of the elderly (MRHE) is an emerging concept of hyponatremia in aged people. Diagnosis of MRHE requires exclusion of syndrome of inappropriate antidiuresis and adrenal dysfunction. Thus we aimed to evaluate the characteristics of all patients with suspected MRHE available for a review.Methods:We conducted a systematic review using MEDLINE and Google scholar. We included published case reports of adult patients diagnosed as MRHE, written by English and Japanese language. Serum and urine electrolytes as well as the levels of antidiuretic hormone (ADH), cortisol, plasma renin activity (PRA), and aldosterone were analyzed.Results:A total of 27 MRHE patients were identified in 9 reports. In these patients, average age was 79 years, median serum sodium was 117 mEq/L. The median levels of ADH, cortisol, PRA, and aldosterone were 0.9 pg/mL, 18.7 μg/dL, 0.37 ng/mL/h, and 39.6 pg/mL, respectively. Water restriction test was conducted in 7 patients. Random sample cortisol measurements did not exceed satisfactory levels to rule out adrenal dysfunction in four cases. No cases underwent low-dose adrenocorticotropic hormone stimulation test. Only 27 patients from 9 case reports in Japanese were eligible for inclusion in our study.Conclusion:All published cases of MRHE as a cause of hyponatremia are described for the first time. In these cases, latent adrenal sufficiency might have been hidden and should have been excluded.

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Three Cases of Mineralocorticoid-responsive Hyponatremia of the Elderly

Cited by 2 publications

References 3 publications

Acute water intoxication in an older woman despite a relatively small amount of water loading

Acute water intoxication in an older woman despite a relatively small amount of water loading

Mineralocorticoid responsive hyponatremia of the elderly

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