ABSTRACT
We report a case of pseudohyponatraemia due to severe hypertriglyceridaemia-induced acute pancreatitis, stemming from unknown diabetes. A woman in her late 30s was admitted to the local hospital by her general practitioner due to severe hyponatraemia (116 mmol/L) and upper abdominal pain. At admission to the hospital, there was a discrepancy of 19 mmol/L between arterial and venous sodium, along with severe hypertriglyceridaemia and hypercholesterolaemia. Pancreatitis was diagnosed using a CT scan. The patient received plasmapheresis which significantly reduced triglycerides, and venous plasma sodium was normalised indicating pseudohyponatraemia at admission. Finally, a haemoglobin A1c of 83 mmol/mol was found. Diabetes was diagnosed, and insulin was initiated.
Subject(s)
Hyperlipidemias , Hypertriglyceridemia , Hyponatremia , Pancreatitis , Acute Disease , Female , Humans , Hypertriglyceridemia/complications , Hyponatremia/diagnosis , Hyponatremia/etiology , Pancreatitis/complications , Pancreatitis/diagnosisABSTRACT
A 23-year-old woman with known tension-type headache and in treatment with oral contraceptives was hospitalized with headache, nausea and vomiting during two weeks. Prior to hospitalization the symptoms had been interpreted as migraine. Blood samples including D-dimer were normal. A computed tomography showed cerebral venous thrombosis (CVT), so the patient was treated with anticoagulation drugs and her symptoms remitted slowly. CVT is a dangerous condition, and the symptoms can have a fluctuating course which can mask the diagnosis. D-dimer cannot be used to exclude CVT, and attention should be paid to the risk factors.