Pseudohyponatremia caused by hyertriglyceridemia: A case report

Brahim Amina Ben; Marrakchi Rim; Boudaya Mariem; Ben Ayed Assawer; Mhadhbi Hayet; Jamoussi Kamel; Turki Mona; Hadj Kacem Faten; Abid Mohamed

doi:10.1530/endoabs.90.EP269

EP269

Prev Next

Section Contents Cite

Endocrine Abstracts (2023) 90 EP269 | DOI: 10.1530/endoabs.90.EP269

ECE2023 Eposter Presentations Diabetes, Obesity, Metabolism and Nutrition (355 abstracts)

Pseudohyponatremia caused by hyertriglyceridemia: A case report

Amina Ben Brahim ¹ , Marrakchi Rim ¹ , Boudaya Mariem ¹ , Ben Ayed Assawer ¹ , Mhadhbi Hayet ¹ , Jamoussi Kamel ¹ , Turki Mona ¹ , Hadj Kacem Faten ² & Abid Mohamed ²

Err

Author affiliations

¹Hedi-Chaker University Hospital, Biochemistry Department, Sfax, Tunisia; ²Hedi-Chaker University Hospital, Endocrinology Department, Sfax, Tunisia

Introduction: Serum sodium assay is one of the most commonly performed laboratory tests in a hospital setting. However, in some instances, the reported laboratory sodium results may not reflect the true actual values. Overcorrection of the serum sodium levels in pseudohyponatremia may cause serious complications

Case Presentation: A 31-year-old woman was hospitalized in June 2022 in endocrinology department for asymptomatic hyponatremia. She was followed in endocrinology department since 2014 for hypertriglyceridemia (Familial hyperlipoproteinemia type 4). She has a history of type 1 diabetes treated withi nsulin since 2009 and 3 episodes of acute pancreatitis (type D and E), the last one was in December 2015. Results of Biochemical parameters at admission were as follows: sodium 124 mmol/l, potassium 3.7 mmol/l, chloride 98 mmol/l, triglyceride 20 mmol/l, cholesterol 4.3 mmol/l, glycemia 3.5 mmol/l. His laboratory results obtained with AU 480® Beckman Coulter. Given the high triglyceride level in the sample as a potential cause of pseudohyponatremia, we used a direct ISE (electrode selective of ions) method on ABL80® Radiometer to check sodium concentration and obtained a result of 139 mmol/l in a sample with a sodium of 124 mmol/l by the indirect ISE on AU 480® Beckman Coulter.

Conclusion: Pseudohyponatremia is a measurement artifact when the fraction of solid-phase particles is more than the physiological range like in hyperlipidemia. Clinicians must be aware about the methods involved in the measurement to prevent mismanagement in such conditions. Direct ISE may be an alternate option in these conditions.