{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:51:15Z","timestamp":1753876275476,"version":"3.41.2"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2021,5,15]],"date-time":"2021-05-15T00:00:00Z","timestamp":1621036800000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,5,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Hyponatraemia is a common problem in patients with heart failure. It can be difficult to treat, especially in the presence of the patient\u2019s needs for diuresis and manipulation of the renin\u2013angiotensin\u2013aldosterone system (RAAS).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>This concerns a 74-year-old woman with follicular lymphoma and severe global left ventricular systolic dysfunction secondary to treatment with R-CHOP chemotherapy. She presented a difficult challenge in the management of her decompensated heart failure alongside hyponatraemia as low as 113\u2009mmol\/L. This was resistant to standard treatment. The resistance to usual measures necessitated treatment with Tolvaptan, a selective arginine vasopressin V2 inhibitor used to treat hyponatraemia in syndrome of inappropriate anti-diuretic hormone. This, along with a strict fluid restriction of 500\u2009mL\/day, resolved the patient\u2019s hyponatraemia and enabled her discharge home on tolerated heart failure treatment. She has now remained stable for almost 12\u2009months.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>The potential causes of hyponatraemia are discussed along with the role of Tolvaptan in its management.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytab183","type":"journal-article","created":{"date-parts":[[2021,5,15]],"date-time":"2021-05-15T10:18:35Z","timestamp":1621073915000},"source":"Crossref","is-referenced-by-count":2,"title":["Resistant hyponatraemia in a patient with follicular lymphoma and heart failure with reduced ejection fraction: a case report"],"prefix":"10.1093","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5804-9913","authenticated-orcid":false,"given":"Jennifer","family":"Butler","sequence":"first","affiliation":[{"name":"Department of Cardiology, Northern General Hospital, Herries Road, Sheffield S5 7AU, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6764-5434","authenticated-orcid":false,"given":"Firas","family":"Miro","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Northern General Hospital, Herries Road, Sheffield S5 7AU, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6517-8692","authenticated-orcid":false,"given":"Abdallah","family":"Al-Mohammad","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Northern General Hospital, Herries Road, Sheffield S5 7AU, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,5,15]]},"reference":[{"key":"2021070816563562000_ytab183-B1","doi-asserted-by":"crossref","first-page":"S30","DOI":"10.1016\/j.amjmed.2006.05.005","article-title":"Incidence and prevalence of hyponatreamia","volume":"119","author":"Upadhyay","year":"2006","journal-title":"Am J Med"},{"key":"2021070816563562000_ytab183-B2","doi-asserted-by":"crossref","first-page":"980","DOI":"10.1093\/eurheartj\/ehl542","article-title":"Relationship between admission serum sodium concentration and clinical outcomes in patients hospitalized for heart failure: an analysis from the OPTIMIZE-HF registry","volume":"28","author":"Gheorghiade","year":"2007","journal-title":"European Heart J"},{"key":"2021070816563562000_ytab183-B3","doi-asserted-by":"crossref","first-page":"57","DOI":"10.15420\/usc.2008.5.1.57","article-title":"Managing hyponatraemia in heart failure","volume":"5","author":"Abraham","year":"2008","journal-title":"US Cardiology"},{"key":"2021070816563562000_ytab183-B4","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1177\/2042098610394233","article-title":"Management of hyponatraemia in older people: old threats and new opportunities","volume":"2","author":"Soiza","year":"2011","journal-title":"Ther Adv Drug Saf"},{"key":"2021070816563562000_ytab183-B5","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1016\/j.ijcard.2020.01.002","article-title":"Angiotensin (1-12): new insights into heart failure pathogenesis","volume":"310","author":"Al-Mohammad","year":"2020","journal-title":"Int J Cardiol"},{"key":"2021070816563562000_ytab183-B6","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1056\/NEJMra1404489","article-title":"Disorders of plasma sodium \u2013 causes, consequences, and correction","volume":"372","author":"Sterns","year":"2015","journal-title":"N Engl J Med"},{"key":"2021070816563562000_ytab183-B7","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/j.amjcard.2005.03.002","article-title":"Hyponatremia in congestive heart failure","volume":"95","author":"Oren","year":"2005","journal-title":"Am J Cardiol"},{"key":"2021070816563562000_ytab183-B8","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.2147\/TCRM.S3115","article-title":"Tolvaptan and its potential in the treatment of hyponatremia","volume":"4","author":"Dixon","year":"2008","journal-title":"Ther Clin Risk Manag"},{"key":"2021070816563562000_ytab183-B9","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1097\/FJC.0000000000000405","article-title":"Tolvaptan for heart failure, systematic review and meta-analysis of trials","volume":"68","author":"Alskaf","year":"2016","journal-title":"J Cardiovasc Pharmacol"},{"key":"2021070816563562000_ytab183-B10","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1056\/NEJMoa1009492","article-title":"Eplerenone in patients with systolic heart failure and mild symptoms","volume":"364","author":"Zannad","year":"2011","journal-title":"N Engl J Med"}],"container-title":["European Heart Journal - 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