Pseudohyponatremia in acute liver disease

Pseudohyponatremia secondary to hypercholesterolemia is a rare condition. In this study, the case of a 41-year-old woman who presented with acute hepatitis C virus infection and normal serum sodium and cholesterol concentrations is presented. Over the course of several weeks, she developed jaundice...

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Bibliographic Details
Published inThe American journal of the medical sciences Vol. 345; no. 1; p. 62
Main Authors Vo, Hieu, Gosmanov, Aidar R, Garcia-Rosell, Melinda, Wall, Barry M
Format Journal Article
LanguageEnglish
Published United States 01.01.2013
Subjects
Adult
Cholestasis, Intrahepatic - etiology
Diabetes Mellitus, Type 2 - complications
Female
Hepatitis C - blood
Hepatitis C - complications
Humans
Hypercholesterolemia - blood
Hypercholesterolemia - complications
Hypercholesterolemia - diagnosis
Hyponatremia - diagnosis
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Summary:Pseudohyponatremia secondary to hypercholesterolemia is a rare condition. In this study, the case of a 41-year-old woman who presented with acute hepatitis C virus infection and normal serum sodium and cholesterol concentrations is presented. Over the course of several weeks, she developed jaundice due to biopsy-confirmed intrahepatic cholestasis and severe hyponatremia, as measured by indirect potentiometry. She was initially intensively treated for hyponatremia. Additional evaluation identified severe hypercholesterolemia, occurring in the absence of lipemic serum. Lipoprotein analysis was consistent with lipoprotein X. Measurement of plasma osmolality and serum sodium concentration using direct potentiometry confirmed the presence of pseudohyponatremia. With supportive care, cholestasis and associated jaundice resolved leading to resolution of both hypercholesterolemia and pseudohyponatremia.
ISSN:1538-2990
DOI:10.1097/MAJ.0b013e3182703327