Thirsty

A 72 year old man presents with fatigue, weakness, thirst and polyuria for 1 month. He appeared to be in good health prior to this.

His medical, surgical and family histories are unremarkable and he is not on any drugs. He does not smoke, and drinks only at social events.

His ESR is found to be 130 mm/1h.

Select Relevant Investigations
Fasting Blood Glucose

Performed

His fasting blood glucose is 90 mg/dl (normal: 70 - 110)
Serum Electrolytes

Performed

Na+: 139 mEq/l
K+: 4.5 mEq/l
Cl-: 97 mEq/l
Ca++: 14.1 mg/dl (range: 8.8 - 10.3)
PO4---: 3.5 mg/dl (range: 3.4 - 4.5)
Renal & Liver functions

Performed

S. Creatinine: 1.5 mg/dl (range: 0.5 - 1.5)
ALT: 35 IU/l (normal)
AST: 28 IU/l (normal)
ALP: 47 IU/l (normal)
Albumin: 3.5 g/dl (normal)
Globulin: 5.8 g/dl (range: 2.3 - 3.5)
Full Blood Count

Performed

WBC/DC: 5,000/mm3

Hb: 9 mg/dl
MCV: 89 fl

Platelets: 190,000/mm3

The blood film shows marked rouleaux formation.

Select Relevant Management
Insulin
IV fluids
Pamidronate
Melphalan