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Published on: April 21, 2012
Hyponatremia in visceral leishmaniasis
Frederico A Lima Verde1, Francisco A A Lima Verde, Francisco José V Veronese
1Instituto de Nefrologia do Ceará, Fortaleza, Ceará, Brasil. elimaverde@hotmail.com
Revista Do Instituto De Medicina Tropical De Sao Paulo
|November 5, 2010
Summary
Hyponatremia, a common complication in visceral leishmaniasis (kala-azar), is linked to persistent antidiuretic hormone secretion. This study suggests syndrome of inappropriate antidiuretic hormone secretion as a likely cause in these patients.
Area of Science:
- Infectious Diseases
- Nephrology
- Endocrinology
Background:
- Visceral leishmaniasis (kala-azar) is a serious parasitic disease.
- Hyponatremia is a frequently observed electrolyte imbalance in kala-azar patients.
- The underlying mechanisms of hyponatremia in kala-azar are not fully understood.
Purpose of the Study:
- To investigate the causes of hyponatremia in patients with visceral leishmaniasis.
- To assess electrolyte and hormone levels in kala-azar patients.
- To determine the prevalence of the syndrome of inappropriate antidiuretic hormone secretion (SIADH) in this population.
Main Methods:
- A study was conducted on 55 consecutive kala-azar patients and 20 healthy controls.
- Serum and urine osmolality, urinary sodium, serum uric acid, and glomerular filtration rate were measured.
- Plasma antidiuretic hormone (ADH) levels were assessed.
Main Results:
- All kala-azar patients exhibited hyponatremia and hypo-osmolality.
- Elevated urine osmolality indicated persistent antidiuretic hormone secretion.
- Low serum uric acid and increased fractional urinary uric acid excretion were observed in a significant portion of patients.
- No evidence of extracellular volume depletion, endocrine, or renal dysfunction was found.
Conclusions:
- Hyponatremia in visceral leishmaniasis is strongly associated with persistent antidiuretic hormone secretion.
- The findings suggest that SIADH is the likely cause of hyponatremia in most affected patients.
- Further research is warranted to confirm the role of SIADH and explore potential therapeutic strategies.
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