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.
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Contributors RSH: Conceptualisation, writing original draft, collected the data, data curation, methodology, performed the systemic search of PubMed and literature review. JFR: Conceptualisation, methodology, critical revision of drafts, laboratory insight and biochemistry angle of the paper. MM: Treated the patient, critical revision of drafts, editing, clinical angle of the paper. LF: Conceptualisation, treated the patient, methodology, critical revision of drafts, editing, idea for figure 1 and table 1, and clinical angle of the paper. All authors approved the submission.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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