A very uncommon clinical entity: Lansoprazole-induced symptomatic hyponatremia in a young woman.

Abstract

A 31-year-old female patient was admitted to the emergency room with nausea, weakness, and headache. Her medical history revealed sudden cardiac arrest because of Prolonged QT syndrome, followed by cardioversion 6 months ago. Coronary angiography imagery was normal but an operation was performed to insert an implantable cardioverter-defibrillator to correct abnormal heart rhythm. One week ago she was admitted to the cardiology clinic with chest pain, and acute pericarditis was diagnosed. Ibuprofen 200 mg tablet b.i.d., colchium dispert 0.5 mg tablets t.i.d., and lansoprozole 30 mg capsule b.i.d. were prescribed. Her family history was positive for sudden cardiac arrest because of Prolonged QT syndrome. She denied ever drinking alcohol, smoking, or using any kind of herbal or folk remedies. Her physical examination revealed decreased heart sounds in auscultation. Abdominal and neurologic examinations were normal. Serum sodium concentration was 115 mmol/L (135-145 mmol/L), potassium was 4.9 mmol/L (3.5-5.5 mmol/L), serum creatinine was 0.63 mg/dL (0.4-1.2 mg/dL), and chloride was 90 mmol/L (97-107 mmol/L). Blood urea nitrogen concentration and liver function tests were within the normal range. A cardiologist had reviewed her in the emergency room, and just a little cardiac effusion was noticed with echocardiogram; no other emergency cardiac pathology was diagnosed. Her abdominal ultrasonographic examination also revealed no pathology. The patient was then hospitalized.