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Published on: July 3, 2013
Severe hyponatremia: an association with lisinopril?
A L Hume1, B W Jack, P Levinson
1Department of Pharmacy Practice, College of Pharmacy, University of Rhode Island, Kingston 02881.
DICP : the Annals of Pharmacotherapy
|December 1, 1990
Summary
This case study highlights how restarting lisinopril, an angiotensin-converting enzyme inhibitor, effectively treated severe hyponatremia (low sodium) in a patient with chronic obstructive pulmonary disease. The patient
Area of Science:
- Nephrology
- Pulmonology
- Internal Medicine
Background:
- A 63-year-old woman with hypertension and COPD presented with severe hyponatremia.
- Initial symptoms included shortness of breath, anorexia, increased thirst, and edema.
Observation:
- The patient had a serum sodium of 109 mmol/L, initially suspected as SIADH due to pneumonia.
- Lisinopril was discontinued, then restarted due to worsening blood pressure.
Findings:
- Restarting lisinopril normalized the patient's serum sodium concentration to 135-140 mmol/L.
- Thyroid, adrenal, hepatic, and cardiac functions were within normal limits.
- The hyponatremia resolved despite continued COPD exacerbations and pneumonia.
Implications:
- ACE inhibitors may play a role in managing certain types of hyponatremia.
- This case suggests a potential mechanism beyond SIADH for hyponatremia in COPD patients.
- Further research is warranted to explore the relationship between ACE inhibitors and electrolyte balance.
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