ECE2024 Eposter Presentations Pituitary and Neuroendocrinology (214 abstracts)
Clinical presentation and comorbidities in hyponatremia: a key to the diagnosis of endocrine cause
Sanja Borozan 1 , Dragana Miljic 2 , Marina Nikolic Djurovic 2 , Mirjana Doknic 2 , Sandra Pekic Djurdjevic 2 , Marko Stojanovic 2 , Zvezdana Jemuovic 3 , Ivana Cekic 3 , Ivan Jevtic 3 , Snezana Vujosevic 1 & Milan Petakov 2
1Clinical Centre of Montenegro, Faculty of Medicine, University of Montenegro, Montenegro;2Faculty of Medicine, Belgrade University, Serbia; Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Center of Serbia, Belgrade, 11 000 Belgrade, Serbia;3Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Center of Serbia, Belgrade, 11 000 Belgrade, Serbia
Introduction: The aim of the study was to establish the predictive factors for endocrine disease-induced hyponatremia.
Patients and methods: Fifty-two patients with hyponatremia (Na <135 nmol/l) were referred to Department of Neuroendocrinology, University Clinical Center of Serbia from January 2015 to March 2023 (n=52; 31 females, 60%) mean age 60.5±14.1 years, mean serum sodium level 124.9±9.0 mmol/l. Seven patients (13.4%) with translocational hyponatremia, caused by hyperglycemia were excluded from the analysis.
Results: No significant differences between the non-endocrine (NEhypoNa) and endocrine hyponatremia (ENhypoNa) group was detected regarding the age (P=0.439), gender (P=0.899), body mass index (P=0.236) and smoking habits (P=0.668). Compared to patients in NEhypoNa group (n=27, 60%), patients with ENhypoNa (n=18, 40%) more frequently presented with rapid-onset hyponatremia (77.8% vs 25.9%, P<0.05). Although mean serum Na was not significantly different between groups (122.8 vs 124.4 mmol/l; P=0.583), severe symptoms were predictive factors for endocrine cause, found in 77.7% of ENhypoNa patients vs 37% in NEhypoNa group (P=0.05). Hypertension was associated with non-endocrine causes of hyponatremia (66.7% in NEhypoNa vs 27.8% in ENhypoNa group; P=0.011), most commonly caused by syndrome of inappropriate diuresis (SIAD). Chronic comorbidities like type 2 diabetes, obesity and osteoporosis were more frequently present in NEhypoNa, but the sample was small so the statistical significance was not reached. In 2/3 of patients in ENhypoNa group hyponatremia unmasked previously unrecognized primary or secondary adrenal insufficiency and hypopituitarism, diagnosed in 6 (13.3%) and 12 (26.7%) patients respectively.
Conclusion: Acute and severe hyponatremia on admission with less chronic comorbidities (diabetes, obesity, hypertension, osteoporosis), more frequently reflected underlying endocrine cause of hyponatremia.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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