What methods can be used to distinguish
pseudohyponatremia from genuine hyponatremia?
Further work-up of the hyponatremia (120 mmol/L) could exclude
pseudohyponatremia (serum osmolality: 267 (normal range: 280-300 mmol/kg)) and adrenal insufficiency by an adrenocorticotropin hormone (ACTH) stimulation test (cortisol basal: 919 nmol/L, 30 min after stimulation with 250 [micro]g ACTH: 1137 nmol/L, and 60 min: 1235 nml/L).
The mechanisms for hyponatremia in alcoholics include hypovolemia,
pseudohyponatremia due to alcohol-induced hypertriglyceridemia, beer potomania syndrome, and rarely SIADH or cerebral salt wasting.
c) Nephrological side effects: Acute renal failure, hyponatremia and
pseudohyponatremia are the main nephrological side effects.
of measurement is termed
pseudohyponatremia in the context of physiologically normal sodium levels and pseudonormonatremia when the result masks physiologically increased sodium.
His electrolytes were within normal limits except for a
pseudohyponatremia of 133 mEq/dL due to an elevated glucose of 549 mg/dL.
(3,4) Displacement of water in a sample may lead to
pseudohyponatremia when electrolytes are measured by indirect methods.
To our knowledge, there is only 1 other report of a PBC patient with a cholesterol concentration >2000 mg/dL (51.7 mmol/L), and it, too, was associated with
pseudohyponatremia significant enough to prompt clinical action (5).
The low sodium concentration was found to be a result of
pseudohyponatremia, an artificially low measurement of sodium concentration produced by the presence of severe hyperproteinemia.