title: Problem based review: the patient presenting with hyponatraemia.
abstract: Hyponatraemia is the most common electrolyte anomaly and is associated with significant morbidity and mortality. Patients with severe hyponatraemia often present to acute medical units with non-specific symptoms which can progress to overt neurological manifestations. There are many causes of hyponatriaemia, the most common being drug-induced causes, particularly thiazide diuretics, and the Syndrome of Inappropriate ADH Secretion (SIADH). Initial assessment should include a careful evaluation of the patient's volume status, which helps to identify the most likely cause. This article utilises a recent case which presented to our AMU to illustrate the importance of a careful and systematic assessment of patients presenting to hospital with hyponatraemia. The new vasopressin receptor antagonists are explored as an option for the management of severe hyponatraemia.
authors.affiliation: FY1 Trainee, The Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, West Midlands.
authors.forename: M
authors.initials: M
authors.lastname: Saeed
authors.affiliation: CT1 in General Medicine, Alexandra Hospital, Redditch, West Midlands.
authors.forename: S
authors.initials: S
authors.lastname: Ahmad
authors.affiliation: Consultant Physician in Acute and Renal Medicine, Walsall Hospitals NHS Trust, Walsall, West Midlands.
authors.forename: A
authors.initials: A
authors.lastname: Hayat
authors.affiliation: Consultant Physician in acute and General Medicine, Walsall Hospitals NHS Trust, Walsall, West Midlands.
authors.forename: S
authors.initials: S
authors.lastname: Saeed
mesh_terms: D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D007010:Hyponatremia / Q000209:etiology* / Q000628:therapy; D007177:Inappropriate ADH Syndrome / Q000150:complications / Q000175:diagnosis; D012964:Sodium / Q000097:blood / Q000652:urine; D049993:Sodium Chloride Symporter Inhibitors / Q000009:adverse effects*
chemical_list: D049993:Sodium Chloride Symporter Inhibitors; D012964:Sodium