Abstract
Hyponatremia is characterized as either “true hyponatremia,” which represents a decrease in the Na+ concentration in the water phase of plasma, or “pseudohyponatremia,” which is due to an increased percentage of protein or lipid in plasma, with a normal plasma water Na+ concentration ([Na+]). Pseudohyponatremia is a known complication of intravenous immunoglobulin (IVIG). Because IVIG has been reported to result in post-infusional hyperproteinemia, IVIG-induced hyponatremia has been attributed to pseudohyponatremia. In this case report, we demonstrate that IVIG therapy can result in true hyponatremia, resulting from sucrose-induced translocation of water from the intracellular compartment (ICF) to the extracellular compartment (ECF), as well as the infusion of a large volume of dilute fluid, in patients with an underlying defect in urinary free water excretion.
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Nguyen, M., Rastogi, A. & Kurtz, I. True hyponatremia secondary to intravenous immunoglobulin. Clin Exp Nephrol 10, 124–126 (2006). https://doi.org/10.1007/s10157-006-0416-9
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DOI: https://doi.org/10.1007/s10157-006-0416-9