Hyponatremia and he fell


Category : Acid-Base & Lytes

78-year-old man admitted after a fall – no fractures.

His labs on admission

125 89 33 128
5.2 22 2.1




He has a history of B-cell lymphoma.

His serum osm are 273 and urine osm 263.

Clinically he is euvolemic (i.e., not orthostatic).  He is bradycardic (we stopped his beta blocker given for previous CABG).

He is new to our hospital, we do not know his previous renal function.


Your question – what further tests do you want?  Can you speculate on his diagnosis?


Comments (1)

Little suspicious he might have mild adrenal insufficiency, low sodium, trending high potassium, bradycardia. ? fall the result of low BP
Perhaps as a consequence of past treatment of his lymphoma.
With his kidneys diluting appropriately, like to see some measure of adrenal function

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