Clinical Case Database / Category: Case Based Discussion

Severe hyponatraemia

Publication details

Dr Vijay Joshi, Mr Ashis Banerjee
Foundation Years Journal, volume 2, issue 7, p.325 (123Doc Education, London, September 2008)


A 79-year-old lady presented with a 3-day history of increasing confusion and reduced mobility. She had an episode of diarrhoea which resolved 3 days prior to admission. She had no other symptoms when seen. She was noted to be on Atenolol 25 mg/day and Bendrofluomethiazide 2.5 mg/day for hypertension, as well as aspirin 75 mg once daily, and diclofenac 75 mg twice daily.

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Dr Vijay Joshi

Trust Registrar in General Integrated Medicine
Chase Farm Hospital
The Ridgeway
Middlesex EN2 8J

Mr Ashis Banerjee (Corresponding author)

Consultant / Honorary Senior Lecturer in Emergency Medicine
Chase Farm Hospital
The Ridgeway
Middlesex EN2 8JL


1. Moore K, Thomson C, Trainer P. Disorders of water balance. Clin Med, 2003, 3:28–33.
2. Verbalis JG. Hyponatremia: A review. Clin Endocrinol Metabol, 1989, 3:499–530.
3. Cluitmans FH, Meinders A. Management of severe hyponatraemia: rapid or slow correction. Am J Med, 1990, 88:161–166.


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T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

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