Abstract:
Hyponatremia, a common electrolyte disorder, usually has a benign clinical course. However, patients with the syndrome of inappropriate antidiuretic hormone secretion (SIADH) can suffer unfavorable outcomes, including mortality. Atypical antipsychotics, which are among the drugs associated with SIADH, also cause tardive dyskinesia, a condition that physicians can now effectively manage with the recently approved agent - valbenazine. We herein report a case of severe hyponatremia due to SIADH in a 58-year-old man who developed hyponatremia-induced generalized seizures six weeks after valbenazine was added to his regimen to mitigate olanzapine-associated tardive dyskinesia. His electrolyte derangement and clinical course improved following prompt recognition and treatment of SIADH. The temporal association between the commencement of valbenazine and the onset of SIADH suggests a possible but previously unreported link between valbenazine and the development of SIADH. Awareness of this uncommon association is relevant to patient safety.
摘要:
低钠血症,一种常见的电解质紊乱,通常有一个良性的临床过程。然而,抗利尿激素分泌不当综合征(SIADH)的患者可能会遭受不利的结局,包括死亡率。非典型抗精神病药,与SIADH相关的药物之一,也会引起迟发性运动障碍,医生现在可以用最近批准的药物-缬草嗪有效治疗。我们在此报告一例因SIADH导致严重低钠血症的58岁男性,在他的治疗方案中添加缬草嗪以减轻奥氮平相关的迟发性运动障碍后六周出现低钠血症引起的全身性癫痫发作。在迅速认识和治疗SIADH后,他的电解质紊乱和临床病程得到改善。缬草那嗪的开始与SIADH的发作之间的时间关联表明,缬草那嗪与SIADH的发展之间可能存在但以前未报道的联系。对这种罕见关联的认识与患者安全有关。