A 35 year old man presents with vomitings and confusion. On examination Na+ 120 m mol/L, K+ 4.2 m mon, Uric acid 2 mg/dl. Patient is not edematous. The diagnosis is:
Answer is A (Cerebral toxoplasmosis with SIADH): The patient in question satisfies all the diagnostic features of SIADH, leaving no doubt as regards the diagnosis. Laboratory parameters in patient Normal values SIADH CRITERIA 1. Serum Na.: 120 mmol/1 i.e. Hyponatremia (137-145 mmol/1) < 135 mmol/1 2. Uric acid: 2 mg/dl i.e. Hypouricemia 2.5-8.5 mg/dl < 4 mg/di 3. Serum ICI': 4.2 mmol i.e. Normokalemia 3.5-4.5 mmol/1 3.5-4.5 mmol/1 Edema does not occur in SIADH despite hypervolumia. The patient in question has distinctly been mentioned as 'non edematous', thus providing us with an impoant lead to the answer.
Cerebral toxoplasmosis with SIADH
Hepatic failure
Severe dehydration
Congestive hea failure