Confounding Hyponatremia and Hypochloremia in a Cancer Patient

Unrecognized hyponatremia and hypochloremia.

Severe hyponatremia in a schizophrenic patient.

A 63-year-old white man with a history of schizophrenia plus polysubstance and alcohol abuse was seen by his primary care physician during a routine visit, at which time he was found to have a serum sodium concentration of 113 mmol/L. The patient was contacted by phone and advised to return to Urgent Care for assessment, but he did not respond until 7 days later, at which time his serum sodium ...

Severe hyponatremia in a patient treated with levomepromazine and carbamazepine.

A 40-year-old man was brought to hospital because of grand mal seizures in July, 2000. Seven hours before admission, he vomited once and drank approximately 6 liters of water within two hours because of throat discomfort. Thirty minutes later, he suffered six grand mal seizures. His medical history included cerebral palsy at the age of one year complicated with mental retardation and absence ep...

Hypochloremia and Diuretic Resistance in Heart Failure

The fundamental role of sodium in maintenance of fluid homeostasis and progression of heart failure (HF) has been a central paradigm in medicine for more than a century. As a result, a core treatment principal in HF management has been the avoidance of dietary sodium. However, accumulating evidence ranging from the basic sciences to epidemiological studies has challenged this paradigm, suggesti...

Hyponatremia in a Patient with a Sellar Mass

A 59-year-old man with confused mental status was admitted to our hospital. Laboratory reports showed him to have severe hyponatremia, and additional studies revealed panhypopituitarism. Brain magnetic resonance imaging showed a sellar cystic lesion, which consisted of a Rathke cleft cyst. Thus, the mass effect of the Rathke cleft cyst resulted in panhypopituitarism and finally induced euvolemi...