Hyponatremia and Myelinolysis
Authors: J. Carlos Ayus
Journal: Annals of Internal Medicine (1997)

Letters15 July 1997Hyponatremia and MyelinolysisJ. Carlos Ayus, MD and Allen I. Arieff, MDJ. Carlos Ayus, MDBaylor College of Medicine; Houston, TX 77024University of California Medical Center; San Francisco, CA 94143 and Allen I. Arieff, MDBaylor College of Medicine; Houston, TX 77024University of California Medical Center; San Francisco, CA 94143Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-127-2-199707150-00016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Drs. Laureno and Karp suggest that in humans, "rapid" correction of symptomatic hyponatremia may have detrimental sequelae, such as myelinolysis [1], despite overwhelming evidence to the contrary [2, 3]. Although absolute correction of hyponatremia in laboratory animals by more than 25 mmol/L in 48 hours can lead to cerebral demyelinating lesions, the "rate" of correction of plasma sodium concentrations in both humans and laboratory animals has been shown to be irrelevant [2, 4]. Most patients who have brain damage associated with hyponatremic encephalopathy are menstruant women who have had a hypoxic episode [4]. Among 117 patients with ...References1. Laureno R, Karp BI. Myelinolysis after correction of hyponatremia. Ann Intern Med. 1997; 126:57-62. Google Scholar2. Sarnaik AP, Meert K, Hackbarth R, Fleischmann L. Management of hyponatremic seizures in children with hypertonic saline: a safe and effective strategy. Crit Care Med. 1991; 19:758-62. Google Scholar3. Tien R, Arieff AI, Kucharczyk W, Wasik A, Kucharczyk J. Hyponatremic encephalopathy: is central pontine myelinolysis a component? Am J Med. 1992; 92:513-22. Google Scholar4. Ayus JC, Arieff AI. Brain damage and postoperative hyponatremia: role of gender. Neurology. 1996; 46:323-8. Google Scholar5. Steele A, Gowrishankar M, Abrahamson S, Mazer CD, Feldman RD, Halpern ML. Postoperative hyponatremia despite near-isotonic saline infusion: a phenomenon of desalination. Ann Intern Med. 1997; 126:20-5. Google Scholar Author, Article, and Disclosure InformationAuthors: J. Carlos Ayus, MD; Allen I. Arieff, MDAffiliations: Baylor College of Medicine; Houston, TX 77024University of California Medical Center; San Francisco, CA 94143Corresponding Author: Robert H. Moser, MD, Canones Road, Box 616, Chama,NM 87520. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byCentral pontine myelinolysis secondary to rapid correction of hyponatremia historical perspective with Doctor Robert LaurenoManagement of Fluid and Electrolyte Abnormalities in ChildrenSodium Disturbances Commonly Encountered in the Neurologic Intensive Care UnitComputation of the excess glucose and Na deficit of hypo-osmolar hyponatremic hyperglycaemiaBURNSSíndrome confusional en paciente con hiponatremia severaBurnsLes hyponatrémies postopératoires de l'enfant : physiopathologie, diagnostic et traitementPoint-of-Care Decision Making, Adaptive Systems and Outcomes Optimization (and the National Directives for Improved Healthcare)Les hyponatrémies en neuroréanimation : syndrome de perte de sel et sécrétion inappropriée d'hormone antidiurétiqueImmunoglobulins Are Effective in Pontine Myelinolysis 15 July 1997Volume 127, Issue 2Page: 163KeywordsAttentionBlood plasmaBrain damageBrain diseasesComputersHyponatremiaLesionsLiver diseasesResearch laboratoriesSodium ePublished: 15 August 2000 Issue Published: 15 July 1997 Copyright & PermissionsCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...