Pseudohyponatraemia caused by acute pancreatitis-derived hypertriglyceridaemia

BMJ Case Rep. 2021 Apr 19;14(4):e241806. doi: 10.1136/bcr-2021-241806.

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.

Keywords: diabetes; pancreatitis.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Female
  • Humans
  • Hyperlipidemias*
  • Hypertriglyceridemia* / complications
  • Hyponatremia* / diagnosis
  • Hyponatremia* / etiology
  • Pancreatitis* / complications
  • Pancreatitis* / diagnosis