Background: Acquired hyponatremia and hypernatremia are common in hospitalized patients and correcting dysnatremia may improve outcomes. Nephrology assistance with dysnatremia may help optimize management, but specialist resources are limited. Targeted Automatic e-Consultation (TACo), a model of selective e-consultation based on automated identification of patients from the electronic health record, has been applied for glycemic management [...]

Case Presentation: Pt was a FT 2wk old boy. At his 1st clinic appointment, he was 9% below birthweight. Mom reported appropriate feeding volume but he was sleeping throughout the day and needed to be woken for feeds. He was stooling 1-2 times per day with 4-5 wet diapers and no vomiting or fevers. At [...]

Case Presentation: A 49-year-old male presented for evaluation of an umbilical hernia. Past medical history was remarkable for alcohol misuse; the patient had ceased all alcohol consumption three years earlier. Physical exam revealed a protuberant, non-tender abdomen with a 4×4 cm reducible umbilical hernia. Pre-operative laboratory exam was remarkable for serum sodium of 137 mmol/L, [...]

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: Mr. M is a 66 year old man with a history of a kidney transplant and extensive coronary disease with a recent myocardial infarction and code blue arrest 2 months prior to admission. He presented to an outside facility with altered mental status and seizures attributed to severe hyponatremia (Na 115). The patient [...]

Case Presentation: A 51 year old Haitian male with a history of hypertension and what he described as “low sodium” presented to the emergency room with 4 days of dizziness, frontal headache, and nausea preceded by a 2 week onset of dry mouth and malaise. He had been prescribed hydrocortisone on a previous hospitalization, which [...]

Case Presentation: A 54-year-old woman with type 2 diabetes mellitus with hyperglycemia and hypertension presented to our hospital with new fevers, nausea, vomiting.Four days prior, the patient was found to have a diabetic foot infection and started on trimethoprim/sulfamethoxazole (TMP-SMX) and metronidazole as an outpatient. At this time, her sodium was 133, corrected to 139 [...]

Case Presentation: 66 year old man with a history of eosinophilic granulomastosis with polyangiitis presented with ascending numbness and unsteadiness that worsened over two days and finally manifested as paraesthesia and weakness in all extremities, gait imbalance, and diplopia. Three weeks prior to presentation, the patient had received the flu vaccine. Neurology was consulted upon [...]

Case Presentation: This is the case of a 57-year-old lady with rapidly progressive stage IV pulmonary adenocarcinoma who presented two months after diagnosis with findings of significant hyponatremia. Upon admission, she was afebrile, hypotensive and tachycardic. Sodium was 119 mEq/L, potassium 2.4 mEq/L, chloride 67 mEq/L, serum osmolality 246 mosm/kg, urine osmolality 684 mosm/kg and [...]

Case Presentation: A 40-year-old woman with diabetes mellitus type 2 and severe malnutrition presented to our institution with symptoms of altered mental status and dysuria. Initial evaluation was most notable for a capillary blood glucose of 1113 mg/dL and initial sodium of 125 mEq/L (which corrected for glucose level was within the normal range of [...]