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Hypoosmolar hyponatremia is a condition where hyponatremia is associated with a low plasma osmolality. [1] The term "hypotonic hyponatremia" is also sometimes used. [2] When the plasma osmolarity is low, the extracellular fluid volume status may be in one of three states: low volume, normal volume, or high volume.
[1] [3] Severe symptoms include confusion, seizures, and coma; [1] [2] [9] death can ensue. [10] The causes of hyponatremia are typically classified by a person's body fluid status into low volume, normal volume, or high volume. [4] Low volume hyponatremia can occur from diarrhea, vomiting, diuretics, and sweating. [4]
[14] [3] Dilutional hyponatremia can happen in diabetics as high glucose levels pull water into the blood stream causing the sodium concentration to be lower. [14] [3] Diagnosis of the cause of hyponatremia relies on three factors: volume status, plasma osmolality, urine sodium levels and urine osmolality. [14] [3]
Hyponatremia in primary adrenal insufficiency is caused by concurrent aldosterone deficiency, resulting in volume depletion, natriuresis, and hyperkalemia. Hypercalcemia is triggered by decreased calcium excretion and accelerated bone resorption throughout an adrenal crisis, which can be exacerbated by volume depletion.
In medicine, not otherwise specified (NOS) is a subcategory in systems of disease/disorder classification such as ICD-9, ICD-10, or DSM-IV.It is generally used to note the presence of an illness where the symptoms presented were sufficient to make a general diagnosis, but where a specific diagnosis was not made.
PPD is also linked with significant reductions in insular cortex volume, [10] although this may be caused by the secondary hyponatraemia. It has been suggested that these deficits lead to moderate to severe cognitive impairments , especially affecting working memory , verbal memory, executive function , attention and motor speed.
The DSM-5 (2013), the current version, also features ICD-9-CM codes, listing them alongside the codes of Chapter V of the ICD-10-CM. On 1 October 2015, the United States health care system officially switched from the ICD-9-CM to the ICD-10-CM. [1] [2] The DSM is the authoritative reference work in diagnosing mental disorders in the world.
Almost a century after the pioneering work of Claude Bernard (1813–1878) in animals, Peters et al, in 1950, reported three patients seen at Yale New Haven Hospital with hyponatremia associated with varying cerebral pathologies and severe dehydration. In each patient, urine sodium losses persisted despite hyponatremia and a high-salt diet.