05 August 2025
: Case report 
Recurrent Severe Hyponatremia Following Polyethylene Glycol Electrolyte Lavage Solution with Ascorbic Acid in a Patient with Undiagnosed Syndrome of Inappropriate Antidiuretic Hormone Secretion
Unusual clinical course, Challenging differential diagnosis, Diagnostic / therapeutic accidents, Management of emergency care, Adverse events of drug therapy, Educational Purpose (only if useful for a systematic review or synthesis)
Koichi Soga
ABCDEFG 1*, Yuto Suzuki BE 1, Fuki Hayakawa BE 1, Takeshi Fujiwara BE 1, Takahiro Ota BE 1, Ikuhiro Kobori BE 1, Masaya Tamano BE 1
DOI: 10.12659/AJCR.948355
Am J Case Rep 2025; 26:e948355
Table 2 Laboratory data obtained after the second colonoscopy resulted in hyponatremia.
| Reference range | ESD (PEG-ELS/Asc) | ||||||
|---|---|---|---|---|---|---|---|
| Day −1 | Day 0 | 12 h | 24 h | Day 3 | Day 9 | ||
| White blood cells (/μL) | 3300–8600 | 4900 | 9900 | 8800 | 6100 | 6900 | 6700 |
| Hemoglobin (g/dL) | 13.7–16.8 | 14.1 | 14.6 | 13.7 | 14.2 | 14.8 | 14.3 |
| Hematocrit (%) | 40.7–50.1 | 43.1 | 40.1 | 42 | 41.1 | 43.9 | 43.7 |
| Platelets (/μL) | 158 000–348 000 | 203 000 | 168 000 | 174 000 | 92 000 | 188 000 | 183 000 |
| C-reactive protein (mg/dL) | 0–0.14 | <0.06 | <0.06 | 0.19 | <0.06 | 0.35 | <0.06 |
| Sodium (mmol/L) | 138–145 | 140 | 122 | 122 | 130 | 140 | 140 |
| Potassium (mmol/L) | 3.6–4.8 | 4.7 | 3.6 | 4.4 | 4.5 | 4.3 | 5.3 |
| Chloride (mmol/L) | 101–108 | 103 | 88 | 101 | 107 | 104 | |
| Urea nitrogen (mg/dL) | 8–20 | 17 | 10 | 8 | 9 | 15 | 14 |
| Creatinine (mg/dL) | 0.65–1.07 | 0.97 | 0.59 | 0.57 | 0.72 | 0.98 | 0.95 |
| Glucose (mg/dL) | 73–109 | 118 | 201 | 128 | 62 | ||
| Serum osmolality (mOsm/kg) | 275–300 | 293 | 259 | 247 | 270 | 281 | 289 |
| ADH (pg/mL) | 0.0–6.7 | 5.4 | |||||
| Urine creatinine (mg/dL) | 27.8 | ||||||
| Urine sodium (mmol/L) | 58 | ||||||
| Urine osmolality (mOsm/L) | 50–1300 | 229 | |||||
| Urine glucose | +/− | ||||||
| Urine ketone | 2+ | ||||||
| ADH – antidiuretic hormone; ESD – endoscopic submucosal dissection; PEG-ELS/Asc – polyethylene glycol electrolyte lavage solution with ascorbic acid. | |||||||