Hansen RS, Revsholm J, Motawea M, Folkestad L. Pseudohyponatraemia caused by acute pancreatitis-derived hypertriglyceridaemia.
BMJ Case Rep 2021;
14:14/4/e241806. [PMID:
33875511 PMCID:
PMC8057565 DOI:
10.1136/bcr-2021-241806]
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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.
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