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Open Access Highly Accessed Case Report

Profound hyponatremia in cirrhosis: a case report

Aaron Lindsay

Author Affiliations

Case Western Reserve University, School of Medicine, 10900 Euclid Ave, Cleveland, OH 44106, USA

Cases Journal 2010, 3:77  doi:10.1186/1757-1626-3-77

Published: 23 March 2010

Abstract

Introduction

Cirrhosis of the liver commonly leads to a state of chronic hypervolemic hyponatremia. Profound exacerbation of the hyponatremic state may occur in patients with decompensated cirrhosis in conjunction with acute stressors such as infection or binge alcohol ingestion.

Case presentation

A 47 year old man with a history of alcoholic cirrhosis presented to the hospital with symptomatic profound hyponatremia (serum sodium concentration of 105 meq/L) due to a recent infection and binge drinking. The patient was treated with antibiotics, diuretics and hypertonic saline and was placed on a fluid restricted diet. The serum sodium level corrected slowly over four days with symptomatic improvement occurring after two days. A brief discussion of the symptoms and treatment of acute and chronic hyponatremia in the setting of cirrhosis is included.

Conclusion

In patients with cirrhosis, it is important to recognize the symptoms of hyponatremia, identify and treat any exacerbating conditions early in their course, and correct the serum sodium concentration slowly with frequent monitoring.