Tea and Porridge Syndrome: A Rare Cause of Severe Hyponatremia

Hyponatremia is a very common electrolyte imbalance in clinical practice and can result from diverse etiologies. Initial evaluation includes assessment of serum and urine osmolality, along with urinary sodium levels. Only a few causes of hyponatremia present with a urine osmolality of less than 100 mOsm/kg. We describe a case of severe hyponatremia with low urine osmolality in a hypertensive woman who presented with insomnia and vomiting. Due to persistent vomiting, she had been consuming a liquid, carbohydrate-only diet with low salt intake and tea, leading to low solute intake hyponatremia, similar to the "tea and toast" syndrome commonly reported in Western countries. In this case, it is more appropriately called "tea and porridge" syndrome.