TY  - JOUR
AU  - Gluvić, Zoran
AU  - Tica, Jelena
AU  - Vujović, Marina
AU  - Rašić-Milutinović, Zorica
AU  - Popović-Radinović, Vesna
AU  - Lačković, Milena
AU  - Obradović, Milan M.
AU  - Isenović, Esma R.
PY  - 2013
UR  - https://vinar.vin.bg.ac.rs/handle/123456789/10321
AB  - Hiponatrijemija je čest elektrolitski poremećaj kod hospitalizovanih bolesnika. Nakon potvrđivanja laboratorijskog nalaza, potrebno je pojavu hiponatrijemiju etiološki razjasniti. Prikaz bolesnika: Bolesnica stara 56 godina, hospitalizovana je zbog evaluacije grčeva nogu i malaksalosti. U biohemijskim nalazima se registruje hipotona hiponatrijemija, te je posumnjano na SIADH (engl. Syndrome of Inappropriate Antidiuretic Hormone Secretion). Evaluacijom SIADH-a, nije nađen uzrok hiponatrijemije. Primenom simptomatske terapije i korekcijom hiponatrijemije, pacijentkinja je otpuštena lako poboljšana. Četiri meseca nakon hospitalizacije, javlja se konfuzna, sa gušenjem, sindromom hiperglikemije i teškim opštem stanjem. Pored toga, kod pacijentkinjw su laboratorijski potvrđene hipotone hiponatrijemije, ultrasonografijom abdomena su viđene metastatske promene na jetri. Ubrzo nakon prijema, dolazi do smrtnog ishoda. Rodbina je odbila obdukciju, te primarno ishodište malignoma nije utrvđeno. Hipotona hiponatrijemija zahteva ozbiljnu kliničku evaluaciju. SIADH je najčešći uzrok hipotone hiponatrijemije, a najvažniji uzrok SIADH-a je maligna bolest. Pažljiva korekcija hiponatrijemije i lečenje osnovne bolesti je osnova lečenja SIADH-a.
AB  - Hyponatremia is a common electrolyte disorder in hospitalized patients. In the case of repetitive biochemically confirmed hyponatremia, it is necessary to find its cause. Case report: a 56-year-old woman was admitted to hospital due to leg cramps and malaise. Routine biochemical analysis revealed hypotonic hyponatremia and Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) was suspected. The cause of hyponatremia was not discovered by means of evaluating SIADH. The patient was simptomatically treated, and discharged in better general condition, with partially corrected hyponatremia. She was advised to restrict water intake and to repeat serum electrolytes and BUN regularly. Four months later, she presented with dyspnea and hyperglycemic syndrome, she was confused and her life was threatened. Beside severe hyponatremia and hyperglycemia, an urgent abdominal ultrasonography showed liver secondaries. Shortly after admission, the patient passed away. Unfortunately, the patient's family refused an autopsy, so the origin of neoplasia has remained unknown. It is necessary to do a thorough clinical evaluation of hypotonic hyponatremia. SIADH, as the most frequent cause of hypotonic hyponatremia, is often a paraneoplastic syndrome. Careful correction of hypotonic hyponatremia and management of the underlying disease is the mainstay of SIADH treatment.
T2  - Medicinska istraživanja
T1  - Malignomom uzrokovana hiponatrijemija - prikaz slučaja
T1  - Malignancy-related hyponatremia: Case report
VL  - 47
IS  - 2
SP  - 49
EP  - 53
DO  - 10.5937/MedIst1302049G
ER  - 

@article{
author = "Gluvić, Zoran and Tica, Jelena and Vujović, Marina and Rašić-Milutinović, Zorica and Popović-Radinović, Vesna and Lačković, Milena and Obradović, Milan M. and Isenović, Esma R.",
year = "2013",
abstract = "Hiponatrijemija je čest elektrolitski poremećaj kod hospitalizovanih bolesnika. Nakon potvrđivanja laboratorijskog nalaza, potrebno je pojavu hiponatrijemiju etiološki razjasniti. Prikaz bolesnika: Bolesnica stara 56 godina, hospitalizovana je zbog evaluacije grčeva nogu i malaksalosti. U biohemijskim nalazima se registruje hipotona hiponatrijemija, te je posumnjano na SIADH (engl. Syndrome of Inappropriate Antidiuretic Hormone Secretion). Evaluacijom SIADH-a, nije nađen uzrok hiponatrijemije. Primenom simptomatske terapije i korekcijom hiponatrijemije, pacijentkinja je otpuštena lako poboljšana. Četiri meseca nakon hospitalizacije, javlja se konfuzna, sa gušenjem, sindromom hiperglikemije i teškim opštem stanjem. Pored toga, kod pacijentkinjw su laboratorijski potvrđene hipotone hiponatrijemije, ultrasonografijom abdomena su viđene metastatske promene na jetri. Ubrzo nakon prijema, dolazi do smrtnog ishoda. Rodbina je odbila obdukciju, te primarno ishodište malignoma nije utrvđeno. Hipotona hiponatrijemija zahteva ozbiljnu kliničku evaluaciju. SIADH je najčešći uzrok hipotone hiponatrijemije, a najvažniji uzrok SIADH-a je maligna bolest. Pažljiva korekcija hiponatrijemije i lečenje osnovne bolesti je osnova lečenja SIADH-a., Hyponatremia is a common electrolyte disorder in hospitalized patients. In the case of repetitive biochemically confirmed hyponatremia, it is necessary to find its cause. Case report: a 56-year-old woman was admitted to hospital due to leg cramps and malaise. Routine biochemical analysis revealed hypotonic hyponatremia and Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) was suspected. The cause of hyponatremia was not discovered by means of evaluating SIADH. The patient was simptomatically treated, and discharged in better general condition, with partially corrected hyponatremia. She was advised to restrict water intake and to repeat serum electrolytes and BUN regularly. Four months later, she presented with dyspnea and hyperglycemic syndrome, she was confused and her life was threatened. Beside severe hyponatremia and hyperglycemia, an urgent abdominal ultrasonography showed liver secondaries. Shortly after admission, the patient passed away. Unfortunately, the patient's family refused an autopsy, so the origin of neoplasia has remained unknown. It is necessary to do a thorough clinical evaluation of hypotonic hyponatremia. SIADH, as the most frequent cause of hypotonic hyponatremia, is often a paraneoplastic syndrome. Careful correction of hypotonic hyponatremia and management of the underlying disease is the mainstay of SIADH treatment.",
journal = "Medicinska istraživanja",
title = "Malignomom uzrokovana hiponatrijemija - prikaz slučaja, Malignancy-related hyponatremia: Case report",
volume = "47",
number = "2",
pages = "49-53",
doi = "10.5937/MedIst1302049G"
}

Gluvić, Z., Tica, J., Vujović, M., Rašić-Milutinović, Z., Popović-Radinović, V., Lačković, M., Obradović, M. M.,& Isenović, E. R.. (2013). Malignomom uzrokovana hiponatrijemija - prikaz slučaja. in Medicinska istraživanja, 47(2), 49-53.
https://doi.org/10.5937/MedIst1302049G

Gluvić Z, Tica J, Vujović M, Rašić-Milutinović Z, Popović-Radinović V, Lačković M, Obradović MM, Isenović ER. Malignomom uzrokovana hiponatrijemija - prikaz slučaja. in Medicinska istraživanja. 2013;47(2):49-53.
doi:10.5937/MedIst1302049G .

Gluvić, Zoran, Tica, Jelena, Vujović, Marina, Rašić-Milutinović, Zorica, Popović-Radinović, Vesna, Lačković, Milena, Obradović, Milan M., Isenović, Esma R., "Malignomom uzrokovana hiponatrijemija - prikaz slučaja" in Medicinska istraživanja, 47, no. 2 (2013):49-53,
https://doi.org/10.5937/MedIst1302049G . .

TY  - JOUR
AU  - Gluvić, Zoran
AU  - Tica, Jelena S.
AU  - Vujović, Marina V.
AU  - Rašić-Milutinović, Zorica R.
AU  - Popović-Radinović, Vesna
AU  - Lačković, Milena M.
AU  - Trpković, Andreja T.
AU  - Isenović, Esma R.
PY  - 2010
UR  - https://vinar.vin.bg.ac.rs/handle/123456789/10328
AB  - Subklinički hipotiroidizam je asimptomatska ili simptomatska tiroidna disfunkcija, koja se karakteriše umerenim porastom nivoa TSH i normalnim nivoima perifernih tiroidnih hormona. Često se otkriva uzgredno. Etiologija subkliničkog hipotiroidizma je identična etiologiji kliničkog hipotiroidizma. Dijagnostikuje se laboratorijski, određivanjem nivoa TSH i perifernih tirodnih frakcija. S'obzirom da je od kliničkog značaja samo perzistentni subklinički hipotiroidizam, za definitivnu potvrdu je neophodno učiniti hormonsku reevaluaciju 6-12 meseci nakon incijalne. Značaj subkliničkog hipotiroidizma je prevashodno u postojanju određenih propratnih pojava, koje mogu značajno uticati na kvalitet života bolesnika (dislipidemija, kardiovaskularni i neurokognitivni poremećaji, infertilitet, poremećaj intrauterinog razvoja ploda). Upravo stoga, lečenje subkliničkog hipotiroidizma malim dozama levotiroksina treba sprovesti u slučajevima gde je korist od supstitucije daleko veća od njenih potencijalnih rizika. Ovaj revijski rad je pokušaj argumentovanog razmatranja kliničkih i terapijskih aspekata subkliničkog hipotiroidizma iz literature i našeg kliničkog iskustva.
AB  - Subclinical hypothyroidism is asymptomatic or symptomatic thyroid dysfunction, presented as slightly elevated TSH level and reference range values of peripheral thyroid hormons. Its etiology is the same as the etiology of clinical hypothyroidism. By measurement of TSH serum level as well the levels of peripheral free thyroid hormone fractions, it is easy, but more frequently incidental, diagnosed. Because of clinical significance is just persistent subclinical hypothyroidism, obliged hormonal confirmation would be done 6-12 months after initial measurement. The importance of subclinical hypothyroidism lay in the co-existence of some accompanying phenomenons, which can significantly influence on the patients life quality (lipid disorders, cardiovascular and neurocognitive dysfunctions, infertility, inadequate fetal growth and deveolpment). For such reasons, it is necessary to substitute subclinical hypothyroidism with small doses of levothyroxine, where we can expect more benefit than the risk of therapy. This review article is an attempt to unite present important clinical and therapeutical aspects of subclinical hypothyroidism from reviews and our experience.
T2  - Materia medica
T1  - Subklinički hipotiroidizam
T1  - Subclinical hypothyroidism
VL  - 26
IS  - 3
SP  - 95
EP  - 100
UR  - https://hdl.handle.net/21.15107/rcub_vinar_10328
ER  - 

@article{
author = "Gluvić, Zoran and Tica, Jelena S. and Vujović, Marina V. and Rašić-Milutinović, Zorica R. and Popović-Radinović, Vesna and Lačković, Milena M. and Trpković, Andreja T. and Isenović, Esma R.",
year = "2010",
abstract = "Subklinički hipotiroidizam je asimptomatska ili simptomatska tiroidna disfunkcija, koja se karakteriše umerenim porastom nivoa TSH i normalnim nivoima perifernih tiroidnih hormona. Često se otkriva uzgredno. Etiologija subkliničkog hipotiroidizma je identična etiologiji kliničkog hipotiroidizma. Dijagnostikuje se laboratorijski, određivanjem nivoa TSH i perifernih tirodnih frakcija. S'obzirom da je od kliničkog značaja samo perzistentni subklinički hipotiroidizam, za definitivnu potvrdu je neophodno učiniti hormonsku reevaluaciju 6-12 meseci nakon incijalne. Značaj subkliničkog hipotiroidizma je prevashodno u postojanju određenih propratnih pojava, koje mogu značajno uticati na kvalitet života bolesnika (dislipidemija, kardiovaskularni i neurokognitivni poremećaji, infertilitet, poremećaj intrauterinog razvoja ploda). Upravo stoga, lečenje subkliničkog hipotiroidizma malim dozama levotiroksina treba sprovesti u slučajevima gde je korist od supstitucije daleko veća od njenih potencijalnih rizika. Ovaj revijski rad je pokušaj argumentovanog razmatranja kliničkih i terapijskih aspekata subkliničkog hipotiroidizma iz literature i našeg kliničkog iskustva., Subclinical hypothyroidism is asymptomatic or symptomatic thyroid dysfunction, presented as slightly elevated TSH level and reference range values of peripheral thyroid hormons. Its etiology is the same as the etiology of clinical hypothyroidism. By measurement of TSH serum level as well the levels of peripheral free thyroid hormone fractions, it is easy, but more frequently incidental, diagnosed. Because of clinical significance is just persistent subclinical hypothyroidism, obliged hormonal confirmation would be done 6-12 months after initial measurement. The importance of subclinical hypothyroidism lay in the co-existence of some accompanying phenomenons, which can significantly influence on the patients life quality (lipid disorders, cardiovascular and neurocognitive dysfunctions, infertility, inadequate fetal growth and deveolpment). For such reasons, it is necessary to substitute subclinical hypothyroidism with small doses of levothyroxine, where we can expect more benefit than the risk of therapy. This review article is an attempt to unite present important clinical and therapeutical aspects of subclinical hypothyroidism from reviews and our experience.",
journal = "Materia medica",
title = "Subklinički hipotiroidizam, Subclinical hypothyroidism",
volume = "26",
number = "3",
pages = "95-100",
url = "https://hdl.handle.net/21.15107/rcub_vinar_10328"
}

Gluvić, Z., Tica, J. S., Vujović, M. V., Rašić-Milutinović, Z. R., Popović-Radinović, V., Lačković, M. M., Trpković, A. T.,& Isenović, E. R.. (2010). Subklinički hipotiroidizam. in Materia medica, 26(3), 95-100.
https://hdl.handle.net/21.15107/rcub_vinar_10328

Gluvić Z, Tica JS, Vujović MV, Rašić-Milutinović ZR, Popović-Radinović V, Lačković MM, Trpković AT, Isenović ER. Subklinički hipotiroidizam. in Materia medica. 2010;26(3):95-100.
https://hdl.handle.net/21.15107/rcub_vinar_10328 .

Gluvić, Zoran, Tica, Jelena S., Vujović, Marina V., Rašić-Milutinović, Zorica R., Popović-Radinović, Vesna, Lačković, Milena M., Trpković, Andreja T., Isenović, Esma R., "Subklinički hipotiroidizam" in Materia medica, 26, no. 3 (2010):95-100,
https://hdl.handle.net/21.15107/rcub_vinar_10328 .