Pseudohyponatremia

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Pseudohyponatremia is defined as a falsely low level of sodium in the bloodstream.

Pathophysiology

Certain conditions that interfere with laboratory tests of serum sodium concentration (such as extraordinarily high blood levels of lipid (hyperlipidemia/hypertriglyceridemia) or protein (hyperparaproteinemia) may lead to an erroneously low measurement of sodium. This is called pseudohyponatremia, and can occur when laboratories use the flame-photometric and indirect (but not direct) ion-selective electrode assays.[1][2] This is distinct from a true dilutional hyponatremia that can be caused by an osmotic shift of water from cells to the bloodstream after large infusions on mannitol or intravenous immunoglobulin.

It is associated with hyperlipidemia more frequently than with elevated protein.[3]

Causes

References

  1. Weisberg LS (1989). "Pseudohyponatremia: a reappraisal". Am. J. Med. 86 (3): 315–8. doi:10.1016/0002-9343(89)90302-1. PMID 2645773. Unknown parameter |month= ignored (help)
  2. Nguyen MK, Ornekian V, Butch AW, Kurtz I (2007). "A new method for determining plasma water content: application in pseudohyponatremia". Am. J. Physiol. Renal Physiol. 292 (5): F1652–6. doi:10.1152/ajprenal.00493.2006. PMID 17299138. Unknown parameter |month= ignored (help)
  3. Garibaldi BT, Cameron SJ, Choi M (2008). "Pseudohyponatremia in a patient with HIV and hepatitis C coinfection". J Gen Intern Med. 23 (2): 202–5. doi:10.1007/s11606-007-0446-3. PMID 17994269. Unknown parameter |month= ignored (help)

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