I would ask is she thirsty or passing lots of urine. Would ask GP for clinical findings and if he has examined abdomen for any swelling. I would get U&E repeated on another specimen, check bicarbonate and chloride and urine sodium and osmolality. Such picture is very rare in an ambulant adult patient. Have not seen in women but in men (sodium 170+) with obstructive uropathy producing NDI. Guess it is possible that in women slow growing gynae pathology could lead to a similar picture.
A
Ahmed Waise,
Consultant Chemical Pathologist
Laboratory Medicine,
York Hospitals Foundation Trust,
YORK, North Yorkshire YO31 8HE, UK
[log in to unmask]
01904725855
---- Original message ----
>Date: Tue, 5 Feb 2008 08:16:00 -0800
>From: Mohammad Al-Jubouri <[log in to unmask]>
>Subject: Severe hypernatraemia
>To: [log in to unmask]
>
> For the sake of "learning clinical biochemistry"
> from our daily routine, may I present you with this
> case for interpreation:
>
>
> An elderly lady, relatively fit and well, had the
> following routine UEs requested by her GP:
>
>
>
> Sodium + 184 mmol/L
>
> Potassium - 3.4 mmol/L
>
> Urea 4.9 mmol/L
>
> Creatinine 78 umol/L
>
> eGFR 75 mL/min/1.73 m2
>
>
>
> All results were double checked and are analytically
> correct.
>
>
>
> What advice would you offer her GP?
>
>
>
> regards
>
>
>
> Mohammad
>
>
> Dr. M A Al-Jubouri
> Consultant Chemical Pathologist
>
> ------------------------------------------------
>
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