Test and teach. Number forty-one. Diagnosis: hypertriglyceridemia with pseudohyponatremia in acute or chronic alcoholism; multiple myeloma with pseudohyponatremia, decreased anion gap and hypercalcemia.
In discussing these 2 patterns, a detailed review has been made of the composition of plasma (in terms of water, proteins, crystalloids and lipids) and of the physico-chemical composition of proteins and lipids. This should enable the reader to give a clearer explanation to his clinical colleagues in instances of pseudohyponatremia from water 'displacement'. Prompt notification to the clinical of the laboratory observation that a specimen of plasma or serum is lipemic may on occasion prevent incorrect and potentially dangerous therapy of a 'low' sodium concentration or even, rarely, an unnecessary laparotomy for acute abdominal pain. It is for these very practical reasons that the examples have been chosen.
D000136:Acid-Base Equilibrium; D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000150:complications*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000175:diagnosis* / Q000209:etiology; D007010:Hyponatremia / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D009101:Multiple Myeloma / Q000150:complications*; D014280:Triglycerides / Q000097:blood*
D014280:Triglycerides