Hyponatremia is an electrolyte disorder frequently encountered in clinical practice. The first step in the diagnostic evaluation of hyponatremia is the volume assessment (clinical estimation of hypo/hypervolemia presence). In the cases of euvolemic hyponatremia, followed by decreased plasma osmolality (<275mOsm/kg) with urine osmolality >100mOsm/kg, urine sodium >30mmol/L along with normal intake of salt and water, preserved pituitary, adrenal, thyroid, adrenal function as well as no recent use of diuretics, syndrome of inappropriate diuresis (SIAD) is diagnosed. In symptomatic, especially acute hyponatremia, careful and gradual substitution by 3 (10) % sodium-chloride infusion is advised with liquid intake restriction, the administration of demeclocycline, urea, or vaptans, as well as causal treatment of SIAD. SIAD is often transient and etiologically clear. In this paper, we present two cases with idiopathic, chronic SIAD with poor outcomes. During the diagnostic follow-up, the cause of SIAD was not found. The autopsy finding was also adverse. In most cases, euvolemic hyponatremia in patients with chronic, idiopathic SIAD is an ominous sign.

This article presents a case of patient with acute and complicated dyslipidaemic pancreatitis, managed by team, consisted of the endocrinologists, gastroenterologists and transfusiologists. Dyslipidaemia, predominantly type IV, is a common cause of acute pancreatitis in young patients, especially in the cases of poor compliance (irregular taking of recommended fibrates and failure to comply with the dietary regime). The treatment of acute pancreatitis, regardless of the aetiology, is due to the severity of the condition, the complexity of the treatment, and the monitoring of patients, in the Intensive Care Units. In cases where dyslipidaemia is the cause of acute pancreatitis, in the context of acute care, a therapeutic plasma exchange is often performed. It rapidly and significantly corrects lipid levels, primarily triglycerides. Therapeutic plasma exchange requires the activity of transfusiology team, which are often unavailable in smaller hospitals.