Thursday, July 16, 2015


Q: What one pitfall should be avoided while treating psychogenic polydipsia by  just fluid restriction?


Answer: Physicians easily tend to fall into a false comfort zone, once it is determined that hyponatremia is secondary only due to psychogenic polydipsia, and just fluid restriction will slowly correct hyponatremia without any further complication. But, even severe hyponatremia can correct rapidly with just fluid restriction, despite that hyponatremia is associated with absent ADH secretion. Correction of hyponatremia too rapidly may cause central pontine myelinolysis (CPM) with permanent neurologic deficits. In all cases, very close monitoring of Sodium level should be maintained irrespective of the cause of hyponatremia.

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