15th August 2023

A 45-year-old woman presents to the Accident and Emergency Department with symptoms of severe lethargy

A 45-year-old woman presents to the Accident and Emergency Department with symptoms of severe lethargy, decreased urine output, and dry skin. She has a medical history of Crohn’s disease. On examination, her blood pressure and heart rate are low, and she has poor skin turgor. Her laboratory results reveal a high haemoglobin and haematocrit, elevated serum osmolality, and increased blood urea nitrogen (BUN) to creatinine ratio.

What is the most likely cause of this patient’s symptoms?