Adolescent Male With Syncope

An 18-year-old previously healthy man presented to the emergency department with 4 weeks of fatigue, a 20-pound weight loss, nonbloody, nonbilious vomiting, and a syncopal episode. He had no other significant symptoms. Vital signs were notable for a pulse rate of 78 beats/min and a blood pressure of 93/53 mm Hg. His physical examination result was unremarkable. Laboratory test results were remarkable for a sodium and potassium level of 132 and 4.7 mmol/L, respectively, with a normal glucose level.

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