A case of pulmonary hyalinizing granuloma characterized by pseudohyponatremia due to hyperproteinemia
A 57-year-old man presented with multiple pulmonary nodules. Thoracoscopic lung biopsy led to a pathological diagnosis of pulmonary hyalinizing granuloma (PHG) at the age of 39 years. The disease was progressive, refractory to therapy, and necessitated home oxygen therapy 10 years after the diagnosi...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-01-01
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| Series: | Respiratory Medicine Case Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213007123000497 |
| _version_ | 1797832276194623488 |
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| author | Mariko Yamauchi Sahoko Kamejima Izumi Yamamoto Ichiro Ohkido Jun Araya Takashi Yokoo |
| author_facet | Mariko Yamauchi Sahoko Kamejima Izumi Yamamoto Ichiro Ohkido Jun Araya Takashi Yokoo |
| author_sort | Mariko Yamauchi |
| collection | DOAJ |
| description | A 57-year-old man presented with multiple pulmonary nodules. Thoracoscopic lung biopsy led to a pathological diagnosis of pulmonary hyalinizing granuloma (PHG) at the age of 39 years. The disease was progressive, refractory to therapy, and necessitated home oxygen therapy 10 years after the diagnosis. Hyponatremia progressed gradually along with lung disease. His serum sodium level was 129 mEq/L but serum osmolality was normal (287 mOsm/kg). Concomitant hyperproteinemia (12.1 g/dL) was attributable to hyperglobulinemia. Direct ion-selective electrode measurement revealed a normal sodium level (137 mmol/L). We herein report a case of PHG characterized by pseudohyponatremia due to hyperproteinemia, an uncommon finding in this rare entity. A left lung transplant was successfully performed, and no pseudohyponatremia was observed. Pseudohyponatremia should be suspected and diagnosed to prevent a misdiagnosis that could lead to complications from inappropriate treatment with sodium supplementation or restriction of drinking water. The direct ion-selective electrode measurement was useful for diagnosing pseudohyponatremia. |
| first_indexed | 2024-04-09T14:06:19Z |
| format | Article |
| id | doaj.art-2cf5cb997f9a43708f625a80649cc8fb |
| institution | Directory Open Access Journal |
| issn | 2213-0071 |
| language | English |
| last_indexed | 2024-04-09T14:06:19Z |
| publishDate | 2023-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Respiratory Medicine Case Reports |
| spelling | doaj.art-2cf5cb997f9a43708f625a80649cc8fb2023-05-07T04:16:52ZengElsevierRespiratory Medicine Case Reports2213-00712023-01-0143101854A case of pulmonary hyalinizing granuloma characterized by pseudohyponatremia due to hyperproteinemiaMariko Yamauchi0Sahoko Kamejima1Izumi Yamamoto2Ichiro Ohkido3Jun Araya4Takashi Yokoo5Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, JapanDivision of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan; Corresponding author. Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo, Japan.Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, JapanDivision of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, JapanDivision of Respiratory Diseases, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, JapanDivision of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, JapanA 57-year-old man presented with multiple pulmonary nodules. Thoracoscopic lung biopsy led to a pathological diagnosis of pulmonary hyalinizing granuloma (PHG) at the age of 39 years. The disease was progressive, refractory to therapy, and necessitated home oxygen therapy 10 years after the diagnosis. Hyponatremia progressed gradually along with lung disease. His serum sodium level was 129 mEq/L but serum osmolality was normal (287 mOsm/kg). Concomitant hyperproteinemia (12.1 g/dL) was attributable to hyperglobulinemia. Direct ion-selective electrode measurement revealed a normal sodium level (137 mmol/L). We herein report a case of PHG characterized by pseudohyponatremia due to hyperproteinemia, an uncommon finding in this rare entity. A left lung transplant was successfully performed, and no pseudohyponatremia was observed. Pseudohyponatremia should be suspected and diagnosed to prevent a misdiagnosis that could lead to complications from inappropriate treatment with sodium supplementation or restriction of drinking water. The direct ion-selective electrode measurement was useful for diagnosing pseudohyponatremia.http://www.sciencedirect.com/science/article/pii/S2213007123000497Pulmonary hyalinizing granulomaPseudohyponatremiaHyperglobulinemia |
| spellingShingle | Mariko Yamauchi Sahoko Kamejima Izumi Yamamoto Ichiro Ohkido Jun Araya Takashi Yokoo A case of pulmonary hyalinizing granuloma characterized by pseudohyponatremia due to hyperproteinemia Respiratory Medicine Case Reports Pulmonary hyalinizing granuloma Pseudohyponatremia Hyperglobulinemia |
| title | A case of pulmonary hyalinizing granuloma characterized by pseudohyponatremia due to hyperproteinemia |
| title_full | A case of pulmonary hyalinizing granuloma characterized by pseudohyponatremia due to hyperproteinemia |
| title_fullStr | A case of pulmonary hyalinizing granuloma characterized by pseudohyponatremia due to hyperproteinemia |
| title_full_unstemmed | A case of pulmonary hyalinizing granuloma characterized by pseudohyponatremia due to hyperproteinemia |
| title_short | A case of pulmonary hyalinizing granuloma characterized by pseudohyponatremia due to hyperproteinemia |
| title_sort | case of pulmonary hyalinizing granuloma characterized by pseudohyponatremia due to hyperproteinemia |
| topic | Pulmonary hyalinizing granuloma Pseudohyponatremia Hyperglobulinemia |
| url | http://www.sciencedirect.com/science/article/pii/S2213007123000497 |
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