Regarding the elevated sodium with normal osmolality:
We had a similar sample a few weeks ago and my final summation was a
collection via a citrate tube as has been previously suggested.
The clincher for me was the repeatable high sodium (170) with a repeatable
normal measured osmolality giving huge anion gap and negative osmolar gap.
As there are few, if any, substances which cause analytical false
elevations for sodium (indirect and direct ISE) or false depressions for
osmolality (freezing point depression) we are looking for a negative ion
with more than one sodium attached. There are a few drugs (I think sodium
clavulinate may be in the di-sodium form) but the numbers work out for our
citrate tubes which are in the form of tri-sodium citrate.
Recollection was normal.
Best wishes,
Graham
Graham Jones
Staff Specialist in Chemical Pathology
St Vincent's Hospital, Sydney
Victoria St, Darlinghurst, 2010
NSW, Australia
Ph: (02) 8382-2170 Fax (02) 8382-2489
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