Case Presentation: A 70-year-old woman visiting from India with history of hypothyroidism and adrenal insufficiency presented with four days of profuse diarrhea and fever. She was admitted for sepsis secondary to Rotavirus gastroenteritis with initial sodium level 132 (135-145 mmol/L). On day 2 of hospitalization, sepsis resolved with isotonic fluids and stress dose steroids, but [...]

Case Presentation: Our patient is a 63-year-old Caucasian male with a past medical history of schizophrenia on risperidone, psychogenic polydipsia and chronic hyponatremia. He presented to the emergency department after being discovered unresponsive in a personal care home. He was tachycardic with a heart rate of 110, hypertensive with a blood pressure of 194/95 mmHg [...]

Case Presentation: Mr. R, a 52 year old man with history of nasopharyngeal carcinoma in remission for 14 years, presented for an elective total laryngectomy. He was doing well post-operatively however had been experiencing uncontrolled anxiety for a few months that was previously controlled by sertraline 100mg. Therefore the medicine team recommended increasing his sertraline [...]

Case Presentation: A 71-year-old man with metastatic melanoma on pembrolizumab, presented with loss of appetite, nausea, vomiting, fatigue, and lightheadedness over the preceding three weeks. He was found to have orthostatic hypotension with dry mucus membranes on physical exam. Laboratory investigation revealed a sodium of 121 mmol/L. An 8am cortisol was checked and found to [...]

Case Presentation: A 40 year old man was brought in by ambulance after having a 30 second tonic-clonic seizure witnessed by his mother. He was intubated on route to the hospital for airway protection. On arrival he was afebrile and hemodynamically stable. Neurological exam was notable for GCS of 8. Pupils were mildly anisocoric and [...]

Case Presentation: 71-year-old male with extensive smoking history was referred to the hospital by his PCP for new-onset severe hyponatremia of 117mMol/L. He denied any active complaints and initial physical examination showed an euvolemic male. Low serum osmolality of 245mOsm/kg but high urine osmolality of 309mOsm/kg and high urine sodium of 68mEq/L were suggestive of [...]