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Hyponatremia in neuromyelitis optica spectrum disorders: Literature review

Hyponatremia in neuromyelitis optica spectrum disorders: Literature review Hyponatremia is a potentially serious electrolyte abnormality observed in neuromyelitis optica spectrum disorders (NMOSDs), and its most common cause is syndrome of inappropriate antidiuretic hormone secretion (SIADH). Another potential cause of hyponatremia is cerebral salt‐wasting syndrome (CSWS), although CSWS has not previously been reported in NMOSDs. Accurate and early differentiation between SIADH and CSWS is difficult. However, the two conditions have important implications for the selection of therapy. Here, we describe two patients with aquaporin‐4 antibody (AQP4‐Ab)‐positive NMOSDs who developed hyponatremia as a result of CSWS and SIADH, respectively. Additionally, we review all previously reported studies of hyponatremia in patients with NMOSDs and propose several potential pathophysiological mechanisms of hyponatremia. In conclusion, NMOSDs accompanied by hyponatremia are not actually rare, but have previously been given little attention. Furthermore, SIADH should not be the only consideration, before the exclusion of rare but significant CSWS. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Acta Neurologica Scandinavica Wiley

Hyponatremia in neuromyelitis optica spectrum disorders: Literature review

Jin, S.; Long, Z.; Wang, W.; Jiang, B.
Acta Neurologica Scandinavica , Volume 138 (1) – Jan 1, 2018
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Publisher
Wiley
Copyright
Copyright © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
ISSN
0001-6314
eISSN
1600-0404
DOI
10.1111/ane.12938
pmid
29654708
Publisher site
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Abstract

Hyponatremia is a potentially serious electrolyte abnormality observed in neuromyelitis optica spectrum disorders (NMOSDs), and its most common cause is syndrome of inappropriate antidiuretic hormone secretion (SIADH). Another potential cause of hyponatremia is cerebral salt‐wasting syndrome (CSWS), although CSWS has not previously been reported in NMOSDs. Accurate and early differentiation between SIADH and CSWS is difficult. However, the two conditions have important implications for the selection of therapy. Here, we describe two patients with aquaporin‐4 antibody (AQP4‐Ab)‐positive NMOSDs who developed hyponatremia as a result of CSWS and SIADH, respectively. Additionally, we review all previously reported studies of hyponatremia in patients with NMOSDs and propose several potential pathophysiological mechanisms of hyponatremia. In conclusion, NMOSDs accompanied by hyponatremia are not actually rare, but have previously been given little attention. Furthermore, SIADH should not be the only consideration, before the exclusion of rare but significant CSWS.

Journal

Acta Neurologica Scandinavica – Wiley

Published: Jan 1, 2018

Keywords: ; ; ; ;

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