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2015 ; 16
(ä): 707-10
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A Rare Mechanism of Hyponatremia in HIV Disease
#MMPMID26436215
Madariaga H
; Kumar A
; Khanna A
Am J Case Rep
2015[Oct]; 16
(ä): 707-10
PMID26436215
show ga
BACKGROUND: Hyponatremia is the most common disorder of body fluid and
electrolyte balance in clinical practice. It is associated with increased
morbidity, mortality, and length of hospital stay. Little is known about the
relationship between hyponatremia and HIV disease. It is thought that
hyponatremia in HIV is associated with a syndrome of inappropriate ADH secretion
(SIADH), volume depletion, and adrenal insufficiency. Another common association
is with Pneumocystis jirovecii (PCP). In early 1990s, there were several reports
linking hyponatremia and HIV disease. It was found that these patients with
acquired immune deficiency syndrome (AIDS) had abnormal adrenal cortical
function. Additionally, these patients showed an abnormally elevated baseline
cortisol level and a blunted response to cosyntropin. CASE REPORT: Here, we
present the case of an HIV patient presenting with hyponatremia and a physical
examination suggestive of hypovolemia. Laboratory tests revealed urinary loss of
sodium in the setting of normal serum cortisol level. The patient responded well
to the administration of a mineralocorticoid hormone. CONCLUSIONS: Glucocorticoid
resistance is an unusual cause of hyponatremia, and needs to be identified and
treated accordingly.
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