カプトプリル投与により著明な低ナトリウム血症を来した拡張型心筋症の1例

Severe hyponatremia associated with Captopril therapy in dilated cardiomyopathy:A case report

　カプトプリルをはじめとするアンギオテンシン変換酵素阻害薬（ACEI）は，高血圧やうっ血性心不全患者の治療に繁用され，その有用性が認識されている。今回我我はカプトプリル治療中に低Na血症を呈した拡張型心筋症の1例を経験したので報告する。

A 47-year-old man, with dilated cardiomyopathy developed severe hyponatremia and hypoosmolarity during captopril therapy. He also had an inappro-priate elevation of antidiuretic hormone and urine osmolarity, but no evidence of dehydration, renal or suprarenal disturbances.

The hyponatremia and hypoosmolarity improved after withdrawal of captopril alone, and recurred after readministration of captopril.

We conclude that the hyponatremia may be caused by high secretion of prostagrandin and bradykinin associated with captopril therapy.