Less is More: Pseudohyponatremia in Multiple Myeloma

Tho, Zhe Lun Bryan; Charles, Judith Sharon; Teo, Desmond B.

doi:10.1016/j.amjmed.2021.09.017

Cited by 3 publications

(3 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Particular attention should be paid to patients in whom serum proteins, which increase the nonaqueous phase of plasma and decrease the plasma water volume, are high. Although well-known cases of pseudohyponatremia have been reported in patients administered intravenous immunoglobulins [ 15 ] and in those with multiple myeloma [ 16 ], this is the first report of pseudohyponatremia in a patient with PHG. This is a valuable report showing the course of PHG after transplantation.…”

Section: Discussionmentioning

confidence: 92%

A case of pulmonary hyalinizing granuloma characterized by pseudohyponatremia due to hyperproteinemia

Yamauchi¹,

Kamejima²,

Yamamoto³

et al. 2023

Respiratory Medicine Case Reports

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 92%

A case of pulmonary hyalinizing granuloma characterized by pseudohyponatremia due to hyperproteinemia

Yamauchi¹,

Kamejima²,

Yamamoto³

et al. 2023

Respiratory Medicine Case Reports

View full text Add to dashboard Cite

“…Table 3 lists clinical states in which pseudohyponatremia has been reported, including conditions associated with hyperproteinemia [41,[66][67][68][69][70][71][72][73][74][75][76][77][78][79][80], hypertriglyceridemia [19,68,[81][82][83][84][85][86][87][88][89][90][91][92][93][94][95][96][97] and hypercholesterolemia [98][99][100][101][102][103][104][105][106][107][108][109][110][111][112]…”

Section: Clinical Conditions Associated With Pseudohyponatremiamentioning

confidence: 99%

“…Table 3 lists clinical states in which pseudohyponatremia has been reported, including conditions associated with hyperproteinemia [ 41 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 ], hypertriglyceridemia [ 19 , 68 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 ] and hypercholesterolemia [ 98 , 99 , 100 , 101 , 102 , 103 , 104 , 105 , 106 , 107 , 108 , 109 , 110 , 111 , 112 , 113 , 114 ].…”

Section: Clinical Conditions Associated With Pseudohyponatremiamentioning

confidence: 99%

Pseudohyponatremia: Mechanism, Diagnosis, Clinical Associations and Management

Aziz

Sam

Lew

et al. 2023

JCM

View full text Add to dashboard Cite

Pseudohyponatremia remains a problem for clinical laboratories. In this study, we analyzed the mechanisms, diagnosis, clinical consequences, and conditions associated with pseudohyponatremia, and future developments for its elimination. The two methods involved assess the serum sodium concentration ([Na]S) using sodium ion-specific electrodes: (a) a direct ion-specific electrode (ISE), and (b) an indirect ISE. A direct ISE does not require dilution of a sample prior to its measurement, whereas an indirect ISE needs pre-measurement sample dilution. [Na]S measurements using an indirect ISE are influenced by abnormal concentrations of serum proteins or lipids. Pseudohyponatremia occurs when the [Na]S is measured with an indirect ISE and the serum solid content concentrations are elevated, resulting in reciprocal depressions in serum water and [Na]S values. Pseudonormonatremia or pseudohypernatremia are encountered in hypoproteinemic patients who have a decreased plasma solids content. Three mechanisms are responsible for pseudohyponatremia: (a) a reduction in the [Na]S due to lower serum water and sodium concentrations, the electrolyte exclusion effect; (b) an increase in the measured sample’s water concentration post-dilution to a greater extent when compared to normal serum, lowering the [Na] in this sample; (c) when serum hyperviscosity reduces serum delivery to the device that apportions serum and diluent. Patients with pseudohyponatremia and a normal [Na]S do not develop water movement across cell membranes and clinical manifestations of hypotonic hyponatremia. Pseudohyponatremia does not require treatment to address the [Na]S, making any inadvertent correction treatment potentially detrimental.

show abstract