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A 56/F who is treated at a nursing facility for aspiration pneumonia and metastatic lung small cell carcinoma to brain is admitted to the hospital with increasing shortness of breath. CXR and CT chest show a lung mass and increasing infiltrates.
Physical examination:
Emaciated patient, visibly short of breath
T 37.2 - HR 110 - RR 20 - BP 140/70 - SpO 92% on 2 L/min NC
Chest: bilateral crackles
CVS: Clear S1S2
Abdomen: cachectic, normoactive bowel sounds, non-tender, not distended
Extremities: full pulses
Laboratory findings:
Total Protein (6.0-8.4 g/dL) = 6.0
Albumin (3.5-5.0 g/dL) = 2.9
Calcium (8.5-10.5 mg/dL) = 7.8
Total Bilirubin (0.0-1.5 mg/dL) = 0.2
Alkaline Phosphatase (40-150 U/L) = 115
AST (7-40 U/L) = 13
ALT (0-45 U/L) = 13
Glucose (65-100 mg/dL) = 499
BUN (8-25 mg/dL) = 15
Creatinine (0.7-1.4 mg/dL) = 0.4
Sodium (132-148 mmol/L) = 128
Potassium (3.5-5.0 mmol/L) = 6.7
Chloride (98-110 mmol/L) = 92
Uric Acid (2.0-7.0 mg/dL) = 2.3
Serum Osmolality (275-295 mOs/kg) = 271
Urine Osmolality (40-1400 mOs/kg) = 593
Physical examination:
Emaciated patient, visibly short of breath
T 37.2 - HR 110 - RR 20 - BP 140/70 - SpO 92% on 2 L/min NC
Chest: bilateral crackles
CVS: Clear S1S2
Abdomen: cachectic, normoactive bowel sounds, non-tender, not distended
Extremities: full pulses
Laboratory findings:
Total Protein (6.0-8.4 g/dL) = 6.0
Albumin (3.5-5.0 g/dL) = 2.9
Calcium (8.5-10.5 mg/dL) = 7.8
Total Bilirubin (0.0-1.5 mg/dL) = 0.2
Alkaline Phosphatase (40-150 U/L) = 115
AST (7-40 U/L) = 13
ALT (0-45 U/L) = 13
Glucose (65-100 mg/dL) = 499
BUN (8-25 mg/dL) = 15
Creatinine (0.7-1.4 mg/dL) = 0.4
Sodium (132-148 mmol/L) = 128
Potassium (3.5-5.0 mmol/L) = 6.7
Chloride (98-110 mmol/L) = 92
Uric Acid (2.0-7.0 mg/dL) = 2.3
Serum Osmolality (275-295 mOs/kg) = 271
Urine Osmolality (40-1400 mOs/kg) = 593
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I found the diagnosis online
SIADH due to Lung Cancer and Aspiration Pneumonia
Author: V. Dimov, M.D., Cleveland Clinic
What is the reason for hyponatremia?
Most likely it is SIADH
...
SIADH due to Lung Cancer and Aspiration Pneumonia
Author: V. Dimov, M.D., Cleveland Clinic
What is the reason for hyponatremia?
Most likely it is SIADH
...
