Hypo-osmolality and hyponatremia

E87.1

Clinical Vignette:

Patient Profile:

* Age: 35 years old

* Sex: Female

* Name: Martha

History of Present Illness:

Martha is a dedicated long-distance runner who recently moved from a temperate climate to an exceptionally hot desert area. To prepare for a marathon in her new environment, she increased her water intake significantly, believing this to be the best way to prevent dehydration. Over the past week, however, she began feeling progressively weaker, with accompanying nausea, headaches, and confusion.

Martha decided to push through her symptoms, attributing them to her rigorous training. However, during her last training session, she felt extraordinarily fatigued and dizzy, leading to a near fainting spell. This prompted her visit to the emergency department.

Physical Examination:

Upon arrival, Martha was lethargic but responsive. Vital signs showed a low blood pressure and a heart rate on the higher side of normal. Physical examination revealed a poor skin turgor despite her excessive water intake.

Investigations and Diagnosis:

Laboratory testing revealed a low sodium level (hyponatremia) and a lower than normal osmolality of her blood (hypo-osmolality). Given her history of excessive water intake and the lab findings, she was diagnosed with water intoxication leading to Hypo-osmolality and Hyponatremia (E87.1). Martha was immediately started on a slow sodium replacement therapy to gradually correct her electrolyte imbalance and was counseled about the dangers of overhydration.

Diagnosis and ICD-10-CM Code:

Hypo-osmolality and Hyponatremia (E87.1)