Syndrome of inappropriate antidiuretic hormone (SIADH) is the most common cause of hyponatraemia. There are many causes of SIADH, but investigation tends to focus around the most common causes—particularly diseases of the brain and lung, malignancy and medication-induced SIADH [Ellison and Berl (2007, The Syndrome of Inappropriate Antidiuresis. N Engl J Med., 356, 2064–72]. We describe a case of SIADH secondary to atonic bladder in an 83-year old woman, which was discovered on MRI of the abdomen, performed for further characterisation of a known pancreatic lesion. Insertion of a urinary catheter alleviated retention and resulted in prompt resolution of hyponatraemia. This is an under-recognised cause of this common condition, with important implications for investigation and management.

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e19104 Background: Pneumocystis Juroveci Pneumonia (PJP) is a life threatening infection by an opportunistic pathogen historically affecting those with HIV and patients with immunosuppression from multiple lines of cytotoxic therapy, with mortality rates often > 50%. We previously reported data showing that PJP can affect patients early in the course of treatment, even during 1st line treatment. We analysed our outcomes from PJP occurring in these patients. Methods: Electronic database records were searched to identify PJP, chemotherapy, lines of therapy and survival. Results: 12 patients were identified who contracted PJP whilst undergoing chemotherapy for solid tumours, 4 during first line therapy and 5 during second line therapy. Age ranged from 33 to 84. 3 of 12 patients died within 1 week of diagnosis, one during first line therapy with erlotinib, 1 after 5 lines of chemotherapy and 1 after 7 lines of chemotherapy. 1 patient who survived had received 10 lines of therapy. Those who survived the initial infection had received between 1 and 10 lines of therapy and survival ranged from 2 to 25 months with a median survival of 11.5 months. Patients contracting PJP during 1-3 lines of therapy had the highest likelihood of survival with median survival of 11 months. Conclusions: PJP had a mortality rate in our series of 25% and was not exclusive to those with multiple lines of chemotherapy. Early recognition of infection resulted in good outcomes with ultimate prognosis being related to underlying malignancy rather than PJP.