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‘Bowel Prep Hyponatremia’ Unmasking Underlying Adrenal Insufficiency

Published:January 09, 2021DOI:https://doi.org/10.1016/j.amjmed.2020.12.010
      A 55-year-old man was admitted to our hospital with nausea and vomiting of sudden onset. One day earlier, he had undergone magnetic resonance colonography for chronic abdominal discomfort and weight loss, reportedly with normal results. In preparation for the procedure, he had consumed a diet literally devoid of protein and salt and ingested copious amounts of fluids over 2 days. On examination, he was afebrile, euvolemic, and appeared tanned. His blood pressure was 122/70 mm Hg, and his heart rate was 70/min. He had a remote history of sarcoidosis. He took aspirin and simvastatin for coronary artery disease.
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