Does Hyponatremia have a Value in the Diagnosis of Extrapulmonary Tuberculosis in HIV-1 Infected Patients in Cambodia?

Lut Lynen1, *, Sok Phan2, Suos Prem Prey3, Thai Sopheak2, Joseph Harwell4, Marleen Boelaert1, Olivier Koole1, Robert Colebunders1, 5
1 Institute of Tropical Medicine, Antwerp, Belgium
2 Sihanouk Hospital Center of HOPE, Phnom Penh, Cambodia
3 NCHADS, National Center for HIV/AIDS Dermatology and STDs
4 The Warren Alpert Medical School at Brown University, division of infectious diseases, departments of internal medicine and pediatrics, Brown University, Providence, Rhodes Island, USA
5 University of Antwerp, Antwerp, Belgium

© 2010 Lynen et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Institute of Tropical Medicine, Antwerp, Belgium. E-mail:


Hyponatremia is a frequent finding in hospitalised HIV-patients. The diagnosis of extra-pulmonary tuberculosis (EPTB) is difficult in resource-limited settings, causing delays in treatment. In this cross-sectional study based on hospital chart review in a charity hospital in Cambodia we found that hyponatremia (serum sodium ` 134 meq/L) was significantly associated with a diagnosis of EPTB in HIV-positive adults. Our findings suggest that hyponatremia in patients with advanced stage of HIV disease should trigger a diagnostic work-up for EPTB.