ArticleAME case reports2025
Severe hyponatremia due to trimethoprim-sulfamethoxazole: a case report.
Article in AME case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
2 citing papers in PubMed.
- Antibiotics and the Endocrine System: Mechanisms, Adverse Effects, and Clinical Implications.Antibiotics (Basel, Switzerland) · 2026Review
- Radiation Recall Pneumonitis withDiseases (Basel, Switzerland) · 2025Article
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Authors and funding
4 authors.
Funding
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Abstract
Background: Hyponatremia, a prevalent electrolyte imbalance with varying degrees of severity, can lead to mild to severe complications. Trimethoprim-sulfamethoxazole (TMP-SMX) and spironolactone are two frequently administered medications; regrettably, most healthcare professionals are not aware that these medications might cause hyponatremia. Concurrently, the two drugs have a high chance of medication interactions that raise the risk of hyponatremia, hyperkalemia, and death overall. TMP-SMX is implicated in causing hyponatremia through diverse mechanisms, such as inhibiting the renal tubular epithelial enzyme carbonic anhydrase. Structurally akin to the potassium-sparing diuretic amiloride, TMP-SMX is linked to hyperkalemia and hyponatremia by obstructing epithelial sodium channels in the distal nephron. Moreover, TMP-SMX may enhance antidiuretic hormone (ADH) release, exacerbating the imbalance. Case Description: This is a case of a 76-year-old man with a medical history including hypertension, type II diabetes, coronary artery disease, and dyslipidemia. This case highlights an elderly patient treated with TMP-SMX for a soft tissue wound infection, which resulted in severe hyponatremia. Conclusions: Timely identification and careful monitoring of TMP-SMX-induced hyponatremia enabled the correction of sodium levels without severe complications. Thus, this report underscores the importance of vigilant monitoring and prompt identification of hyponatremia in patients undergoing TMP-SMX treatment. Further research is warranted due to limited data on the precise mechanisms of TMP-SMX-induced hyponatremia.
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