PMID- 14742828
OWN - NLM
STAT- MEDLINE
DCOM- 20040525
LR  - 20131121
IS  - 1060-0280 (Print)
IS  - 1060-0280 (Linking)
VI  - 38
IP  - 3
DP  - 2004 Mar
TI  - Heparin-induced hyponatremia.
PG  - 404-7
AB  - OBJECTIVE: To report a case of hyponatremia in a patient receiving systemic 
      unfractionated heparin (UFH) therapy and parenteral nutrition. CASE SUMMARY: A 
      70-year-old African American woman was started on parenteral nutrition for 
      postoperative ileus following an elective surgical procedure. Three days later, 
      she was diagnosed with a pulmonary embolism and intravenous UFH therapy was 
      initiated. During the 7-day course of UFH therapy, the patient's serum sodium 
      concentration steadily declined and urine sodium concentration progressively 
      increased. Physical examination revealed no signs or symptoms of hypo- or 
      hypervolemia. The patient's serum potassium concentration increased modestly, 
      although significant hyperkalemia was not observed. After discontinuation of UFH, 
      serum concentrations of both sodium and potassium returned to baseline levels. 
      DISCUSSION: Although heparin-induced hyperkalemia is well documented, cases 
      associated with substantial hyponatremia have been reported less frequently. An 
      objective causality assessment revealed that the adverse drug reaction was 
      probable in this case. Hyponatremia and hyperkalemia result from the antagonism 
      of aldosterone by UFH within the zona glomerulosa of the adrenal glands. 
      CONCLUSIONS: The use of UFH may result in significant hyponatremia as well as 
      hyperkalemia. Reversal of these electrolyte disturbances occurs after 
      discontinuation of heparin.
FAU - Norman, N Elizabeth
AU  - Norman NE
AD  - Department of Pharmacy, The Regional Medical Center at Memphis, TN 38103-2807, 
      USA. enorman@the-med.org
FAU - Sneed, Angela M
AU  - Sneed AM
FAU - Brown, Christine
AU  - Brown C
FAU - Ellis, Cecilia A
AU  - Ellis CA
FAU - Minard, Gayle
AU  - Minard G
FAU - Brown, Rex O
AU  - Brown RO
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20040112
PL  - United States
TA  - Ann Pharmacother
JT  - The Annals of pharmacotherapy
JID - 9203131
RN  - 0 (Anticoagulants)
RN  - 9005-49-6 (Heparin)
RN  - RWP5GA015D (Potassium)
SB  - IM
MH  - Aged
MH  - Anticoagulants/*adverse effects
MH  - Female
MH  - Heparin/*adverse effects
MH  - Humans
MH  - Hyponatremia/*chemically induced
MH  - Parenteral Nutrition
MH  - Postoperative Complications
MH  - Potassium/blood
MH  - Pulmonary Embolism/*drug therapy
EDAT- 2004/01/27 05:00
MHDA- 2004/05/27 05:00
CRDT- 2004/01/27 05:00
PHST- 2004/01/27 05:00 [pubmed]
PHST- 2004/05/27 05:00 [medline]
PHST- 2004/01/27 05:00 [entrez]
AID - aph.1C442 [pii]
AID - 10.1345/aph.1C442 [doi]
PST - ppublish
SO  - Ann Pharmacother. 2004 Mar;38(3):404-7. doi: 10.1345/aph.1C442. Epub 2004 Jan 12.