Hyponatremia accompanying volatile hypertension caused by baroreflex failure after neck surgery: Case report and literature review

Pantelis A. Sarafidis, Marieta Theodorakopoulou, Konstantina Dipla, Andreas Zafeiridis, Afroditi Boutou, Charalampos Loutradis, Danae Faitatzidou, Aikaterini Papagianni, Gianfranco Parati

Research output: Contribution to journalArticlepeer-review

Abstract

The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is the most common cause of euvolemic hyponatremia, and many disorders have been associated with it. Baroreflex failure is a rare disorder characterized by extreme blood pressure (BP) fluctuations, most frequently caused by neck or head trauma and irradiation. We report a case of a 48-year-old patient referred to our department for asymptomatic hyponatremia and volatile hypertension. His past medical history included nasopharyngeal carcinoma treated with surgery and bilateral neck radiation. Following the diagnostic algorithm for hyponatremia, the diagnosis of SIADH was made. Ambulatory BP monitoring revealed highly variable BP; extensive autonomic nervous system function testing suggested baroreflex-cardiovagal failure. We propose the hypothesis that not only labile hypertension because of baroreflex failure but also hyponatremia can develop as a late consequence of neck trauma and irradiation.

Original languageEnglish
Pages (from-to)1617-1624
Number of pages8
JournalJournal of Hypertension
Volume38
Issue number8
DOIs
Publication statusPublished - Aug 1 2020

Keywords

  • baroreflex failure syndrome
  • blood pressure variability
  • hyponatremia
  • syndrome of inappropriate antidiuretic hormone secretion

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

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