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Beyond Occam's Razor: Concurrent Non-functional Pituitary Macroadenoma and Metastatic Hepatocellular Carcinoma in a Patient With Functional Cure of Hepatitis B.
Cureus
June 2024
Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, TWN.
Article Synopsis
- Occam's razor suggests finding a single diagnosis from various symptoms, while Hickam's dictum encourages considering multiple diagnoses, especially in complex cases.
- The case of a 72-year-old man shows the importance of Hickam's dictum, as initial diagnoses missed co-existing metastatic cancers linked to his chronic fatigue and hyponatremia.
- This emphasizes the need for healthcare providers to consider multiple potential conditions and remain cautious about liver cancer risks in patients with a history of hepatitis B, even after a functional cure.
Severe Hyponatremia Triggered by Immune Checkpoint Inhibitor Therapy in a Patient With Mulvihill-Smith Syndrome.
AACE Clin Case Rep
March 2024
Division of Endocrinology, Department of Medicine, Montefiore Medical Center, Bronx, New York.
Background/objective: Immune checkpoint inhibitors (ICI), including Programmed Cell Death 1, Programmed Cell Death Ligand 1, and Cytotoxic T-lymphocyte Associated Antigen 4 inhibitors, upregulate T-cell responses against tumor cells and are becoming a cornerstone in the treatment of various advanced solid and hematological cancers. Mulvihill-Smith Syndrome (MSS) is a rare genetic syndrome that has been associated with metabolic abnormalities and early-onset tumors, including malignancies. We report the first known case of ICI-induced hyponatremia attributable to syndrome of inappropriate antidiuretic hormone ADH release (SIADH) in a patient with MSS.
View Article and Find Full Text PDFImpact of hyponatremia in patients hospitalized in Internal Medicine units: Hyponatremia in Internal Medicine units.
Medicine (Baltimore)
May 2024
Department of Medicine, University of Seville, Seville, Spain.
The aim of this study was to analyze the impact and the clinical and evolutionary characteristics of hypotonic hyponatremia in patients hospitalized in Internal Medicine units. Prospective multicenter observational study of patients with hypotonic hyponatremia (<135 mmol/L) in 5 hospitals in southern Spain. Patients were included according to point prevalence studies carried out every 2 weeks between March 2015 and October 2017, by assessing demographic, clinical, analytical, and management data; each patient was subsequently followed up for 12 months, during which time mortality and readmissions were assessed.
View Article and Find Full Text PDFCerebral Salt Wasting Syndrome in the Setting of Hypovolemic Isotonic Hyponatremia: A Case Report.
Cureus
December 2023
Graduate Medical Education, Baylor Scott and White All Saints Medical Center, Fort Worth, USA.
Cerebral salt wasting syndrome (CSWS) is a condition characterized as the loss of sodium secondarily due to an intracranial process, commonly following the neurosurgical resection of mass lesions. This condition leads to a hypovolemic hypotonic hyponatremia. The identification of this syndrome is often mistaken for syndrome of inappropriate anti-diuretic hormone (SIADH).
View Article and Find Full Text PDFDiagnosis and Management of Sodium Disorders: Hyponatremia and Hypernatremia.
Am Fam Physician
November 2023
La Crosse-Mayo Family Medicine Residency, Mayo Clinic Health System, La Crosse, Wisconsin.
Hyponatremia and hypernatremia are electrolyte disorders that can be associated with poor outcomes. Hyponatremia is considered mild when the sodium concentration is 130 to 134 mEq per L, moderate when 125 to 129 mEq per L, and severe when less than 125 mEq per L. Mild symptoms include nausea, vomiting, weakness, headache, and mild neurocognitive deficits.
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