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JAMA Diagnostic Test Interpretation
March 24/31, 2015

Evaluating Hyponatremia

Author Affiliations
  • 1Division of Nephrology and Hypertension, Department of Medicine, Oregon Health & Science University, Portland
  • 2Department of Cell and Developmental Biology, Oregon Health & Science University, Portland
  • 3Portland VA Medical Center, Portland, Oregon
  • 4Department of Physiology and Pharmacology, Oregon Health & Science University, Portland

Copyright 2015 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA. 2015;313(12):1260-1261. doi:10.1001/jama.2014.13967

A woman in her 30s presented with gradually worsening abdominal pain and was found to have hyponatremia. A glioma of the optic chiasm was treated 20 years prior with chemotherapy and radiation. Sequelae included chronic headaches, anterior hypopituitarism, and hydrocephalus necessitating a ventriculoperitoneal shunt. Medications included analgesics, cyclobenzaprine, sumatriptan, ondansetron, divalproex sodium, gabapentin, furosemide, somatotropin, potassium chloride, vitamin D, and estrogen. Haloperidol was recently added. Blood pressure was 125/87 mm Hg. Mucosae were moist and jugular venous pressure was not well seen. Her cardiopulmonary and abdominal examinations were normal, peripheral edema was absent, and sensorium was clear. Table 1 shows initial laboratory data.