Diabetes insipidus and SIADH Quiz: Ace Your Exams

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A 30 year-old woman comes to her primary care physician because of muscle cramps, nausea, and fatigue. The patient endorses a history of depression and seizure disorder, both of which are currently managed with medications. Family history is notable for Addison disease in her maternal uncle. Temperature is 36.9°C (98.4°F), pulse is 75/min, respirations are 14/min and blood pressure is 115/80 mmHg. Cardiac, pulmonary, and abdominal examinations are noncontributory. Additional laboratory results are as follows:  
 
Laboratory value  Result 
Sodium   122 mEq/L 
 Potassium   3.7 mEq/L 
 Creatinine  0.9 mg/dL 
 Glucose  102 mg/dL 
 Serum osmolality   240 mOsm/kg 
 Urine osmolality  445 mOsm/kg 

Which of the following is the most likely explanation of the patient’s symptoms?

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