Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918

This article has now been updated. Please use the final version.

Recurrent Vomiting due to Severe Hyponatremic-Hypertensive Syndrome in an Elderly Patient
Koki MorishitaKaito NakamuraTakafumi KubotaYusuke OtaMirei NabuchiKeita HibakoYoshimoto SerizawaTetsuya Hoshi
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JOURNAL OPEN ACCESS Advance online publication

Article ID: 4725-24

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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.

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