{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T19:18:27Z","timestamp":1766517507631,"version":"3.48.0"},"reference-count":0,"publisher":"Sociedad Argentina de Gastroenterologia","issue":"4","license":[{"start":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T00:00:00Z","timestamp":1766448000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ACTA"],"abstract":"<jats:p>La hiponatremia severa es una complicaci\u00f3n frecuente (21,6%) en pacientes con cirrosis descompensada y, en ocasiones, puede manifestarse como un s\u00edndrome paraneopl\u00e1sico que precede al diagn\u00f3stico de c\u00e1ncer en un 5% de los casos; se asocia principalmente a c\u00e1ncer de pulm\u00f3n (25\u201345%), pero tambi\u00e9n a c\u00e1ncer colorrectal, c\u00e1ncer de mama y linfomas, reflejando la complejidad de las interacciones entre la enfermedad hep\u00e1tica y los procesos oncol\u00f3gicos. En los pacientes con cirrosis descompensada, la hiponatremia suele producirse por la incapacidad renal para excretar agua libre de solutos, lo que genera diluci\u00f3n del sodio plasm\u00e1tico; sin embargo, en el contexto oncol\u00f3gico, mecanismos como la secreci\u00f3n ect\u00f3pica de hormona antidiur\u00e9tica por los tumores pueden exacerbar esta alteraci\u00f3n. Este s\u00edndrome de secreci\u00f3n inadecuada de hormona antidiur\u00e9tica conduce a una retenci\u00f3n adicional de agua y agrava la hiponatremia. Presentamos dos casos cl\u00ednicos que ilustran esta relaci\u00f3n: un paciente con met\u00e1stasis hep\u00e1ticas y una paciente con n\u00f3dulos pulmonares, ambos con cirrosis compensada como enfermedad cr\u00f3nica de base, que ingresaron con hiponatremia severa. El manejo de estos pacientes requiere un enfoque multidisciplinario orientado a la b\u00fasqueda de neoplasias ocultas y a la correcci\u00f3n cuidadosa de los niveles de sodio para evitar complicaciones neurol\u00f3gicas, siendo la identificaci\u00f3n temprana de la hiponatremia crucial por su impacto pron\u00f3stico.<\/jats:p>","DOI":"10.52787\/agl.v55i4.480","type":"journal-article","created":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T19:15:31Z","timestamp":1766517331000},"page":"386-391","source":"Crossref","is-referenced-by-count":0,"title":["Hiponatremia severa como marcadora de malignidad en pacientes con cirrosis hep\u00e1tica. Implicancias cl\u00ednicas y relevancia pron\u00f3stica en dos casos"],"prefix":"10.52787","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-6030-2173","authenticated-orcid":false,"given":"Jonatan Nicol\u00e1s","family":"Dom\u00ednguez","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda Jos\u00e9","family":"C\u00e1ceres","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6330-1423","authenticated-orcid":false,"given":"Liria","family":"Mart\u00ednez Rejtman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5901-0690","authenticated-orcid":false,"given":"Mat\u00edas","family":"Zanetti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6048-6397","authenticated-orcid":false,"given":"Rub\u00e9n Guillermo","family":"Fern\u00e1ndez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2761-9893","authenticated-orcid":false,"given":"Mariano","family":"Arguello","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"30608","published-online":{"date-parts":[[2025,12,23]]},"container-title":["Acta Gastroenterol\u00f3gica Latinoamericana"],"original-title":[],"link":[{"URL":"https:\/\/actaojs.org.ar\/ojs\/index.php\/acta\/article\/download\/480\/918","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/actaojs.org.ar\/ojs\/index.php\/acta\/article\/download\/480\/938","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/actaojs.org.ar\/ojs\/index.php\/acta\/article\/download\/480\/938","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T19:15:32Z","timestamp":1766517332000},"score":1,"resource":{"primary":{"URL":"https:\/\/actaojs.org.ar\/ojs\/index.php\/acta\/article\/view\/480"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,23]]},"references-count":0,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,12,23]]}},"URL":"https:\/\/doi.org\/10.52787\/agl.v55i4.480","relation":{},"ISSN":["2469-1119"],"issn-type":[{"value":"2469-1119","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,23]]}}}