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A Case Report of Hemolytic Hyponatremia

Santiago Manrique-Castaño1, Luisa Rodríguez-Rosero2, Raúl Vallejo-Serna2

  • 1Internal Medicine, Hospital Universitario San Jorge, Pereira, COL.

Cureus
|March 4, 2024
PubMed

Hereditary spherocytosis/elliptocytosis is a non-immune hemolytic anemia caused by an alteration in the erythrocyte membrane that predisposes the cell to its lysis. This report presents a case of a 42-year-old woman with a history of spontaneous abortion, associated with postpartum bleeding, chronic anemia, and premature menopause. After five years, she consulted due to alterations in the state of consciousness and severe symptomatic hyponatremia, with a diagnosis of hypopituitarism, explained by a late Sheehan syndrome. During hospitalization, she developed non-immune hemolytic anemia associated with a positive osmotic fragility test. A diagnosis of hereditary spherocytosis/elliptocytosis was made. We correlate blood hypoosmolarity as a trigger with the in vitro hypotonic solution of the osmotic fragility test for the diagnosis of this disease. This association is not reported in the literature; in our case, we show the concomitant improvement of anemia with the increase in sodium levels and hormonal replacement.

Keywords:
anemiahereditary spherocytosishypopituitarismsheehan’s syndromesickel cell

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