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SIADH and hyponatremia with theophylline.
Evagelos N Liberopoulos1, George H Alexandridis, Dimitris S Christidis
1Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece.
The Annals of Pharmacotherapy
|June 28, 2002
Summary
Theophylline may cause hyponatremia (low sodium levels) by triggering syndrome of inappropriate antidiuretic hormone (SIADH). This rare adverse effect warrants consideration in patients presenting with hyponatremia.
Area of Science:
- Nephrology
- Endocrinology
- Pharmacology
Background:
- Hyponatremia is a common electrolyte imbalance, often associated with significant morbidity.
- Theophylline, a medication used for respiratory conditions, has rarely been linked to hyponatremia.
Observation:
- An 88-year-old male developed severe symptomatic hyponatremia (serum sodium 112 mEq/L) after initiating theophylline therapy.
- The patient exhibited inappropriate natriuresis (urinary sodium 58 mEq/L), consistent with SIADH.
- Other potential causes of hyponatremia and SIADH were excluded.
Findings:
- The clinical presentation strongly suggests theophylline as the causative agent for SIADH-induced hyponatremia.
- A potential mechanism involves a thiazide-like action of theophylline, stimulating SIADH.
Implications:
- Theophylline should be recognized as a potential cause of hyponatremia, particularly SIADH.
- Clinicians should consider theophylline in the differential diagnosis of hyponatremia, especially in patients receiving the medication.
- Further research may elucidate the precise mechanism of theophylline-induced SIADH.