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Case report: severe symptomatic hyponatremia associated with lisinopril therapy
1Department of Medicine, Baylor College of Medicine, Houston, Texas.
The American Journal of the Medical Sciences
|March 1, 1992
Summary
Lisinopril, an ACE-inhibitor, can cause severe hyponatremia (low sodium) leading to seizures and altered mental status. Discontinuation of the drug resolved the condition.
Area of Science:
- Nephrology
- Endocrinology
- Pharmacology
Background:
- Hypertension is a common condition often managed with medications like lisinopril.
- Angiotensin-converting enzyme (ACE) inhibitors are frequently prescribed for hypertension.
Observation:
- A 63-year-old female on lisinopril developed seizures and altered mental status.
- Her serum sodium level dropped significantly from 137 mEq/L to 101 mEq/L after starting lisinopril.
Findings:
- The severe hyponatremia was directly linked to lisinopril therapy.
- Stopping lisinopril led to the correction of serum sodium levels.
- The mechanism may involve polydipsia and inappropriate antidiuresis induced by ACE inhibitors.
Implications:
- Clinicians should consider ACE-inhibitor-induced hyponatremia in patients presenting with neurological symptoms and low sodium.
- Monitoring serum electrolytes is crucial during ACE inhibitor treatment.
- Understanding this adverse effect aids in timely diagnosis and management of potentially life-threatening hyponatremia.