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Pantoprazole-related Symptomatic Hyponatremia
Filipa Ferreira1, Sofia Mateus2, Ana Rita Santos2
1Oncology Department, Hospital São Francisco Xavier - Centro Hospitalar Lisboa Ocidental, Portugal.
European Journal of Case Reports in Internal Medicine
|February 14, 2019
Summary
Severe hyponatremia, a common electrolyte disorder, can be caused by pantoprazole, a proton pump inhibitor. Discontinuing the medication normalized sodium levels in an elderly patient, highlighting the need for careful prescription.
Area of Science:
- Endocrinology
- Nephrology
- Geriatrics
Background:
- Hyponatremia is a prevalent electrolyte disorder, particularly in elderly and polymedicated individuals.
- Proton pump inhibitors (PPIs) are frequently prescribed, increasing the risk of drug-induced electrolyte imbalances.
- Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) is a known cause of hyponatremia.
Purpose of the Study:
- To report a case of severe symptomatic hyponatremia.
- To identify pantoprazole as the causative agent for SIADH-induced hyponatremia.
- To emphasize the importance of considering PPIs in the differential diagnosis of hyponatremia.
Main Methods:
- Case report of an 83-year-old male patient.
- Clinical evaluation and laboratory analysis for electrolyte imbalance.
- Medication review and discontinuation of suspected causative agent (pantoprazole).
Main Results:
- The patient presented with severe symptomatic hyponatremia.
- Hyponatremia was attributed to SIADH secondary to pantoprazole use.
- Discontinuation of pantoprazole led to normalization of serum sodium levels within two months.
- This represents the second reported case of pantoprazole-induced hyponatremia, with this patient experiencing severe symptoms.
Conclusions:
- The association between proton pump inhibitors (PPIs) and hyponatremia warrants consideration in elderly patients.
- Hyponatremia is linked to adverse outcomes, including fractures, falls, prolonged hospitalization, and increased mortality.
- Judicious prescribing practices, including individual risk-benefit assessment, are crucial for medication management.
