Severe osteoporosis – the story of chronic medication-related hyponatremia

Česká verzia

Authors: Pavel Polák ^1,2,3; Petr Husa ¹; Hana Matějovská Kubešová ²
Authors place of work: Klinika infekčních chorob LF MU a FN Brno ¹; Klinika interní, geriatrická, ošetřovatelství a praktického lékařství LF MU a FN Brno ²; Oddělení klinické hematologie FN Brno ³
Published in the journal: Vnitř Lék 2016; 62(2): 152-156
Category: Case Reports

Summary

The authors present a case-report of a 73years old woman treated for arterial hypertension within past 15 years with diuretics (thiazides, amiloride and indapamide) and concomitantly with antidepressive trazodone. The patient developed severe osteoporosis after 6 years of such a treatment with multiple fractures even after minor trauma; during whole this period severe hyponatremia without adequate supplementation was documented. Most probably, there exists tight relationship of osteoporosis and hyponatremia in this patient – the authors discuss possible pathophysiological mechanisms at the level of renal tubules, osteoblasts and osteoclasts, hypopituitary-skeletal axis, syndrome of inadequate adiuretin secretion (SIADH) and possible influence of acid-base balance disturbances.

Key words:
alkalosis – antidepressive drugs – diuretics – hyponatremia – osteoporosis

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