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Bilateral acute angle closure glaucoma associated with hydrochlorothiazide-induced hyponatraemia
Sylvia H Chen1, Rustum Karanjia2, Robert L Chevrier1
1University of Ottawa Eye Institute, Ottawa, Ontario, Canada.
BMJ Case Reports
|December 6, 2014
Summary
A woman developed acute angle closure due to low sodium levels (hyponatremia). Symptoms resolved after stopping hydrochlorothiazide and restricting fluids, suggesting a link between hyponatremia and angle closure.
Area of Science:
- Ophthalmology
- Endocrinology
- Nephrology
Background:
- Acute angle closure glaucoma is an ophthalmic emergency.
- Hydrochlorothiazide is a common diuretic used to treat hypertension and edema.
- Hyponatremia, or low blood sodium, can have various causes and neurological implications.
Observation:
- A 67-year-old female presented with bilateral acute angle closure.
- Investigations revealed bilateral ciliary effusions and severe hyponatremia.
- The patient was taking hydrochlorothiazide prior to symptom onset.
Findings:
- Ciliary effusions resolved following discontinuation of hydrochlorothiazide.
- Normalization of serum sodium levels through fluid restriction led to resolution of effusions.
- A potential causal link between hyponatremia and acute angle closure was observed.
Implications:
- This case highlights a novel association between hyponatremia and acute angle closure.
- Physicians should consider diuretic-induced hyponatremia in patients presenting with acute angle closure.
- Further research is warranted to elucidate the mechanism linking hyponatremia to ciliary effusions and angle closure.
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