Summary
In the present study frequency and mechanisms of alterations in serum electrolytes in multiple myeloma were investigated. Asymptomatic hyponatremia (up to 93 mmol/l) was present in 7 of 15 patients. Water of serum was significantly lower, viscosity of serum significantly raised as compared to healthy controls. A highly significant negative correlation between sodium concentration and viscosity was found. By measuring serum sodium concentration with viscosity independent dilution systems it could be proved that in each case the observed hyponatremia was caused by flaws in our routinely used viscosity dependent dilution method. The decrease in water of serum contributed only little to the development of hyponatremia. It is concluded that the decrease in serum sodium concentration in multiple myeloma is nothing else than a feigned hyponatremia which needs no therapy.
Zusammenfassung
In der vorliegenden Arbeit wurden Häufigkeit und Ursachen von Elektrolytstörungen bei malignen Paraproteinämien untersucht. 7 von 15 Patienten wiesen z.T. extreme (bis 93 mmol/l), jedoch immer symptomlose Hyponatriämien auf. Gegenüber einer Kontrollgruppe war die Serumviskosität signifikant erhöht. Zwischen der Serumnatriumkonzentration und der Viskosität bestand eine hochsignifikante negative Korrelation. Die Kontrolle der Serumnatriumwerte durch viskositätsunabhängige Meßsysteme erwies, daß die beobachteten Hyponatriämien durch Verdünnungsfehler in dem von uns routinemäßig verwandten viskositätsabhängigen Analyseverfahren bedingt waren. Die Erniedrigung des Serumwasseranteils trug in geringem Maße ebenfalls zur Entstehung einer Hyponatriämie bei. Bei der durch Paraproteine hervorgerufenen Serumnatriumverminderung handelt es sich nach unseren Befunden um eine vorgetäuschte und nicht behandlungsbedürftige Hyponatriämie.
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Overlack, A., Niederle, N., Klautke, G. et al. Vorgetäuschte Hyponatriämie bei malignen Paraproteinämien. Klin Wochenschr 58, 875–880 (1980). https://doi.org/10.1007/BF01476999
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DOI: https://doi.org/10.1007/BF01476999