[ncbi.nlm.nih.gov], Pseudohyponatremia has been reported in association with severe hypertriglyceridemia and hyperparaproteinemia, but its association with severe hypercholesterolemia is not Date: MAY.1.2016 https://medical-dictionary.thefreedictionary.com/pseudohyponatremia. Other conditions that can mimic psychogenic polydipsia include ecstasy intoxication, This case shows that extreme hypercholesterolemia from elevation of lipoprotein-X particles in cholestasis can be a rare cause of, She was ultimately found to have a total serum cholesterol level of 2415 mg/dL (normal range: 120-199 mg/dL) - secondary to accumulation of lipoprotein-X-causing, […] exercise. [clinchem.aaccjnls.org], Although an increase in solids can cause significant pseudohyponatremia, it is not intuitive that a TC concentration of approximately 2100 mg/dL would cause the degree of // [healio.com], Pseudohyponatremia in a myeloma patient: direct electrode potentiometry is a method worthits salt. [aafp.org], Pseudohyponatremia in the setting of hyperlipidemia, hypertriglyceridemia, or hyperparaproteinemia represents a laboratory artifact due to lower plasma water concentration Pseudohyponatremia Symptom Checker: Possible causes include Hyponatremia. Also required are clinical assessment and additional laboratory investigations that may include measuring urine osmolality, serum aldosterone, cortisol, and natriuretic peptide levels. [ncbi.nlm.nih.gov], Hyponatremia is a frequent finding and reflects pseudohyponatremia secondary to hyperlipidemia. Further work-up of the hyponatremia (120 mmol/L) could exclude. [clinlabnavigator.com], […] psychogenic polydipsia, Ecstasy use, or beer potomania) or markedly elevated blood glucose, or a normal serum osmolality (suggesting hyperglycemia-induced hyponatremia and pseudohyponatremia This information should not be considered complete, up to date, and is not intended to be used in place of a visit, consultation, or advice of a legal, medical, or any other professional. [jamanetwork.com], Hyperproteinemia of sufficient magnitude to induce pseudohyponatremia commonly is due to coexisting multiple myeloma. [cancertherapyadvisor.com], It is critical to measure serum osmolality to rule-out pseudohyponatremia (see page 7) an artifact of indirect lab techniques. What methods are used to determine serum osmolality? In such a case, measured sodium levels can be corrected by adding 1.6 to 2.4 mmol of sodium for every 100 mg/dL of glucose above 100 mg/dL. Howard JM, Reed J. Pseudohyponatremia in acute hyperlipemic pancreatitis. Serum osmolality is measured using either freezing point depression or vapor pressure techniques. pseudohyponatremia [soo″do-hi″po-nah-tre´me-ah] a decreased serum sodium concentration that does not correspond to a real hypotonic disorder, i.e., the serum osmolality is normal. [1] Pseudohyponatremia [edit] Certain conditions, such as extraordinarily high [en.wikipedia.org] Hyponatremia in patients with normal osmolality (isotonicity) suggests the presence of pseudohyponatremia , for which corrective action is not required. Nephrogenic Syndrome of Inappropriate Antidiuresis, Glycogen Storage Disease due to Glucose-6-Phosphat Transport Defect. American Journal of Physiology. Enter symptoms or answer a question with "Yes". It can be associated with pseudohyponatremia, or with isotonic infusion of glucose or mannitol. Hyponatremia in patients with normal osmolality (isotonicity) suggests the presence of pseudohyponatremia, for which corrective action is not required. 20, 21 Persons with hyperglycemia have pseudohyponatremia In such a case, measured sodium levels can be corrected by adding 1.6 to 2.4 mmol of sodium for every 100 mg/dL of glucose above 100 mg/dL. [frontiersin.org], /Expanded Normal/high Cerebral salt wasting Contracted Very high Nephrogenic SIADH Expanded High Runner’s Hyponatremia Contracted Low Hyperglycemia Contracted Low/normal Pseudohyponatremia [emedicine.medscape.com], Pseudohyponatremia (disorder) Salt deficiency Schroeder's syndrome Sodium deficiency Sodium deficiency Sodium deficiency (disorder) ICD 10 CM 2017, (Clinical Modification High osmolality can also suggest the presence of other solutes such as mannitol. Labs measure serum sodium with an ion-selective electrode (ISE) using one of two approaches: the indirect method, which involves diluting the sample prior to measurement, and the direct method, which uses neat, undiluted sample. [wisegeek.com], This case shows that extreme hypercholesterolemia from elevation of lipoprotein-X particles in cholestasis can be a rare cause of pseudohyponatremia. AACC.org [care.diabetesjournals.org], Pseudohyponatremia can occur when sodium is measured with an indirect ISE, which is the method used by most automated chemistry analyzers. [jamanetwork.com], pseudohyponatremia seen here. [ncbi.nlm.nih.gov], Hyponatremia can be broadly divided into two fundamental categories: "true hyponatremia" (in which the serum sodium concentration is truly less than normal), or "pseudohyponatremia ⚕ Symptoma®️ is a digital health assistant but no replacement for the opinion and judgement of medical professionals. [intechopen.com], Pseudohyponatremia. [clinicaladvisor.com], Pseudonormoglycemia ( 44 ) and pseudohyponatremia ( 45 ) may occur in DKA in the presence of severe chylomicronemia. [ncbi.nlm.nih.gov], We conclude that besides pseudohyponatremia, extreme hypertriglyceridemia can rarely present as pseudoacidosis and uniparental disomy can be an underlying mechanism for autosomal [ncbi.nlm.nih.gov], She was ultimately found to have a total serum cholesterol level of 2415 mg/dL (normal range: 120-199 mg/dL) - secondary to accumulation of lipoprotein-X-causing pseudohyponatremia [9] pseudohyponatremia It occurs when hyperlipemia increases the serum non-water volume or hyperproteinemia increases the serum non-sodium solute. Primary kidney disease and kidney disease secondary to systemic disorders may rarely occur during pregnancy, resulting in proteinuria. Ibrahim A. Hashim, PhD, DABCC, FACB, is the Arthur J. Gill Professor of Pathology, chief of clinical pathology, and clinical chemistry director at the University of Texas Southwestern Medical Center in Dallas. [galiciaclinica.info], コリンエステラーゼ pseudocroup 仮性クループ pseudocyst of pancreas 仮性膵嚢胞 pseudohermaphroditism 仮性半陰陽【旧名】【不適切】　類語：性分化疾患 DSD【推奨】 pseudohypertrophy 仮性肥大/偽性肥大 pseudohypoaldosteronism 偽性低アルドステロン症 pseudohyponatremia The medical information provided on this website is of a general nature and can not substitute for the advice of a medical professional (for example, a qualified doctor or physician)! Several formulas are available for calculating serum osmolality, but this one is the most widely used: osmolality = 2 x [Sodium] + [Glucose]/18 + [Urea]/2.8. It is always for the medical professional to make the final diagnosis. What does high serum osmolality indicate? A 34-year-old woman was admitted to our hospital with abdominal distention and[…] [jadweb.org], […] spinal cord trauma associated with a traumatic brain or carrier of diseases prior to brain injury may develop brain salt loser syndrome[6],[8]. 20, 21 Persons with hyperglycemia have, […] tyrosine phosphatase 1Bチロシンホスファターゼ1B protein tyrosine phosphatase familyチロシンホスファターゼ類似タンパク protein tyrosine phosphatase, non-receptor type 22非受容体22型チロシンホスファターゼ proteinuriaタンパク尿, Sometimes a treating physician encounters a low serum sodium level following administration of some substances such as lipid or Glucose bloodstream in the blood also called, […] spinal cord trauma associated with a traumatic brain or carrier of diseases prior to brain injury may develop brain salt loser syndrome[6],[8]. First, hyperglycemia causes hypertonic hyponatremia. [web.archive.org], "A new method for determining plasma water content: application in pseudohyponatremia". [1] Pseudohyponatremia[edit] Certain conditions, such as extraordinarily high AACC uses Cookies to ensure the best website experience. Primary kidney disease and kidney disease secondary to systemic disorders may rarely occur during pregnancy, resulting in proteinuria. Sodium is the predominant extracellular solute and major contributor to serum osmolality, while other constituents include glucose and urea. Okerberg K, Lee M. A potential pitfall in therapy. A low serum sodium concentration due to volume displacement by massive hyperlipidemia or hyperproteinemia; also used to describe the low serum sodium concentration that may occur with high blood glucose. [emedicine.medscape.com], Later, she was diagnosed with pancreatitis, and with the concomitant presence of small gallstones and chylomicronemia syndrome, so the hyponatremia was proved to be a pseudohyponatremia [jadweb.org], /Expanded Normal/high Cerebral salt wasting Contracted Very high Nephrogenic SIADH Expanded High Runner's Hyponatremia Contracted Low Hyperglycemia Contracted Low/normal Pseudohyponatremia Talk to our Chatbot to narrow down your search. Fax // +1.202.887.5093, © 2020 American Association for Clinical Chemistry. [care.diabetesjournals.org], […] hyperlipidemia, which is occasionally seen in DKA, could reduce serum glucose ( 154 ) and sodium ( 155 ) levels, factitiously leading to pseudohypo- or normoglycemia and pseudohyponatremia [merck.com], Severe hypertriglyceridemia and hyperproteinemia are two causes of this condition in patients with pseudohyponatremia. The Journal of Applied Laboratory Medicine, Online Course: Quality Management Systems, Clinical Chemistry Journal Continuing Education Credits, Avoiding the Temptation to Sweep Errors Under the Rug, Challenging Times for Mass Spectrometry Reimbursement, Listening Closely when the Volume is Turned Down, Next Generation Clinical Mass Spectrometry and the Future of Precision Medicine, The Case for Population Based BRCA1 and BRCA2 Testing, Commission on Accreditation in Clinical Chemistry. Am J Emerg Med 1985;3:236-9. This artifactual low sodium (so-called pseudohyponatremia) is secondary to measurement by flame photometry. These patients usually are euvolemic. By using this website you fully understand and accept that it shall not be used as a diagnostic system for decision-making. [accessmedicine.mhmedical.com], Pseudohyponatremia occurs when seemingly low sodium levels are actually normal. [aafp.org], Serum osmolality Serum osmolality readily differentiates between true hyponatremia and pseudohyponatremia.