Rapid-onset hyponatremia and delirium following duloxetine treatment for postherpetic neuralgia: Case report and literature review.
Rapid-onset hyponatremia and delirium following duloxetine treatment for postherpetic neuralgia: Case report and literature review.
复制标题
度洛西汀治疗带状疱疹后神经痛后快速发生的低钠血症和谵妄：病例报告和文献综述。
DOI：
10.1097/md.0000000000013178
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发表时间：
2018-11
期刊：
影响因子：
1.6
通讯作者：
Xu Y
中科院分区：
文献类型：
--
作者：
Wang D;Lai J;Lu S;Huang M;Hu S;Xu Y
在重度抑郁症、纤维肌痛、糖尿病性神经病变或坐骨神经痛患者中报告了度洛昔单抗治疗后的低钠血症。度洛西汀引起的低钠血症的表现在不同的个体中是不同的。如果处理得当，这种类型的低钠血症的总体预后是有利的。在此，我们报告了一名老年患者在服用2剂度洛西汀（用于控制带状疱疹后神经痛）后出现快速发作的低钠血症和谵妄。实验室检查显示血清钠水平迅速下降，提示抗利尿激素分泌不当综合征（SIADH）的可能性。采用停用度洛沙坦、限制饮水、静脉补充生理盐水等措施治疗低钠血症。血清钠浓度在上述策略后逐渐正常化。在接受度洛沙汀治疗的老年患者中，建议特别注意电解质异常。
Hyponatremia following duloxetine treatment has been reported in patients with major depressive disorder, fibromyalgia, diabetic neuropathy, or sciatic pain. The manifestations of duloxetine-induced hyponatremia are varying in different individuals. The overall prognosis for this type of hyponatremia is favorable if properly managed. Herein, we reported rapid-onset hyponatremia and delirium in an older patient after 2 doses of duloxetine, which was used to control his postherpetic neuralgia. Laboratory examinations revealed a rapid decline in serum sodium level and indicated the possibility of syndrome of inappropriate antidiuretic hormone (SIADH). Discontinuation of duloxetine, restriction of water intake, and intravenous supplement of normal saline were adopted to manage the hyponatremia. Serum concentration of sodium gradually normalized following aforementioned strategies. Special attention to the electrolyte abnormality is recommended in old patients undergoing duloxetine treatment.