Dr. Silanda
An often forgotten cause for hyperpigmentation will be discussed during the case presentation.
Always consider the following drugs as causes of hyperpigmentation:
Chemotherapeutic agents
Bleomycin
Cyclophosphamide
Doxorubicin
5-FU
Hydroxyurea
Methotrexate
Antimalarials
Aminoquinolones
Hormones
Oral contraceptives
Heavy metals
Arsenic
Gold
Iron
Lead
Mercury
Silver
Miscellaneous
Amiodarone
Clofazimine
Diltiazem
Minocycline
Psoralens
Psychotropic agents (amitryptiline, chlorpromazine, dezipramine)
Zidovudine
Dr. Sikhipha
Clinical pearls
1. Ensure that all cases of hyponatraemia receive appropriate work-up to determine the cause
2. Manage the hyponatraemia according to the cause, e.g. if normal saline in the case of hypovolaemia and glucocorticoids in the case of adrenal insufficiency
3. For patients requiring emergent treatment, e.g. those with seizures, a correction rate of 4-6mmol/L over the first 6 hours is recommended
For further reading, please click:
Disorders of plasma sodium - causes, consequences and correction (PDF)
