{
  "abstract": "Hyponatremia is the most common electrolyte imbalance in hospitalised patients. Common causes for hyponatremia include: endocrine disorders, severe diarrhoea, vomiting, congestive heart failure, liver disease, kidney disease and SIADH. Here we present a case of neuroborreliosis complicated by severe hyponatremia as a presenting clinical feature.A male in his 60s presented with: constipation, altered sensation to his abdomen and left thigh, right eye droop, and binocular diplopia. His initial serum sodium level was 114mmol/L. This was initially ascribed to psychogenic polydipsia. However, further investigations of serum and CSF was positive for Borrelia Burgdorferi. He was treated with ceftriaxone 2g BD for 21 days. Over this treatment period his neurological symptoms and serum sodium improved with diplopia resolving within a matter of days.This case highlights hyponatraemia as a rare early clinical manifestation of neuroborreliosis. Review of the literature suggests this is caused by SIADH. Early recognition of an association between hyponatremia and cranial nerve palsies and polyradiculopathy should prompt screening to facilitate early diagnosis and commencement of appropriate treatment.ismail.ahmed@srft.nhs.uk",
  "authors": [
    {
      "affiliations": [
        "Northern Care Alliance NHS Foundation Trust"
      ],
      "name": "Ahmed Ismail"
    },
    {
      "affiliations": [
        "Northern Care Alliance NHS Foundation Trust"
      ],
      "name": "Almaliki Elias"
    },
    {
      "affiliations": [
        "Northern Care Alliance NHS Foundation Trust"
      ],
      "name": "Singh Chaitram"
    },
    {
      "affiliations": [
        "Northern Care Alliance NHS Foundation Trust"
      ],
      "name": "Murphy Christopher"
    },
    {
      "affiliations": [
        "Northern Care Alliance NHS Foundation Trust"
      ],
      "name": "Lilleker James B"
    }
  ],
  "title": "141 Severe hyponatraemia leading to a diagnosis of neuroborreliosis",
  "uid": "f4612b9c-dc07-5839-98aa-0514de65a91d"
}