A case of severe hyponatremia due to linezolid-induced SIADH

Abstract

This is the second case of a linezolid-induced SIADH, diagnosed with a thorough work-up so to correctly differentiate between SIADH from other causes of hyponatremia.

A retrospective test for a possible relationship between linezolid‐induced thrombocytopenia and hyponatraemia

“…On the other hand, ALB level but not Ccr was identified as an independent variable affecting the development of hyponatraemia, suggesting that the risk of hyponatraemia increases when ALB level is low (Table 4). Four cases of hyponatraemia while receiving LZD therapy have been reported 14‐17 . In two of the four cases, a contributing factor for hyponatremia has signalled strongly a syndrome of inappropriate antidiuretic hormone secretion (SIADH) 15,16 .…”

“…Four cases of hyponatraemia while receiving LZD therapy have been reported 14‐17 . In two of the four cases, a contributing factor for hyponatremia has signalled strongly a syndrome of inappropriate antidiuretic hormone secretion (SIADH) 15,16 . SIADH is a condition of unsuppressed antidiuretic hormone (ADH) secretion from the posterior pituitary gland despite reduced serum osmotic pressure, followed by hypotonia due to relative ADH excess and persistent hyponatraemia 27 .…”

“…Hyponatraemia can cause a wide range of clinical symptoms, from minor symptoms such as headaches, nausea and anorexia to severe and even life‐threatening conditions 13 . Thus far, four cases of severe hyponatraemia occurring while receiving LZD have been reported 14‐17 …”

A case of Linezolid-AssociatedHyponatremia in a Saudi Patient

“…Likewise, our patient was also on a diuretic; however on a loop diuretic (bumetanide) not a potassium sparing diuretic. As diuretics are well known to cause hypoonatremia on their own it alone could not explain the observation of the sudden drop post initiation of linezolid in the study by Tanaka et al in addition to the other case reports identified [6,7,8] .Together with the improvement and rise in sodium levels upon discontinuation of linezolid described in the reported cases increase the likelihood of association.…”

“…There are certain medications with well-known mechanism to cause hyponatremia and can affect the sodium and water homeostasis such as diuretics, or affect water homeostasis via increasing hypothalamic production of ADH such as antidepressants [5] . Hyponatremia is not a labeled adverse drug reaction with linezolid, our search of the literature identified three case reports and a retrospective cohort study that reported the incidence of hyponatremia in a cohort of 61 Japanese patients receiving linezolid [6,7,8,9] .…”