{"title":"Recurrent Vomiting due to Severe Hyponatremic-Hypertensive Syndrome in an Elderly Patient.","authors":"Koki Morishita, Kaito Nakamura, Takafumi Kubota, Yusuke Ota, Mirei Nabuchi, Keita Hibako, Yoshimoto Serizawa, Tetsuya Hoshi","doi":"10.2169/internalmedicine.4725-24","DOIUrl":null,"url":null,"abstract":"<p><p>Hyponatremic hypertensive syndrome (HHS) is a rare disorder, particularly in adults. A 76-year-old woman presented with vomiting and severe hyponatremia. The patient had been hospitalized four times over the past four years due to hyponatremia and recurrent vomiting. On admission, magnetic resonance angiography revealed left renal artery stenosis, which led to a diagnosis of HHS. Treatment with enalapril followed by tolvaptan improved the patient's condition, without the need for renal artery angioplasty. HHS should therefore be considered in patients with hyponatremia, hypertension, or recurrent vomiting. In addition to angiotensin-converting enzyme inhibitors and renal artery angioplasty, tolvaptan may also be a new effective treatment option for HHS.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":""},"PeriodicalIF":1.0000,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Internal Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2169/internalmedicine.4725-24","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
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Abstract
Hyponatremic hypertensive syndrome (HHS) is a rare disorder, particularly in adults. A 76-year-old woman presented with vomiting and severe hyponatremia. The patient had been hospitalized four times over the past four years due to hyponatremia and recurrent vomiting. On admission, magnetic resonance angiography revealed left renal artery stenosis, which led to a diagnosis of HHS. Treatment with enalapril followed by tolvaptan improved the patient's condition, without the need for renal artery angioplasty. HHS should therefore be considered in patients with hyponatremia, hypertension, or recurrent vomiting. In addition to angiotensin-converting enzyme inhibitors and renal artery angioplasty, tolvaptan may also be a new effective treatment option for HHS.
期刊介绍：
Internal Medicine is an open-access online only journal published monthly by the Japanese Society of Internal Medicine.
Articles must be prepared in accordance with "The Uniform Requirements for Manuscripts Submitted to Biomedical Journals (see Annals of Internal Medicine 108: 258-265, 1988), must be contributed solely to the Internal Medicine, and become the property of the Japanese Society of Internal Medicine. Statements contained therein are the responsibility of the author(s). The Society reserves copyright and renewal on all published material and such material may not be reproduced in any form without the written permission of the Society.
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