Symptomatic Hyponatremia after Voluntary Excessive Water Ingestion in a Patient without Psychiatric Problems

• Published in: ENDOCRINE JOURNAL Vol. 54; no. 4; pp. 643 - 645
• Main Authors: HIRAMATSU, Rikako, TAGUCHI, Manabu, TAKESHITA, Akira, TAKEUCHI, Yasuhiro
• Format: Journal Article
• Language: English
• Published: Japan The Japan Endocrine Society 2007
• Subjects: Drinking Behavior; Female; Humans; Hyponatremia - etiology; Hyponatremia - psychology; Mental Health; Middle Aged; SIADH; Water intoxication; Water Intoxication - complications; Water Intoxication - psychology
• ISSN: 0918-8959; 1348-4540
• DOI: 10.1507/endocrj.K07-025

Water intoxication usually happens in patients with a psychiatric problem, who are subject to compulsive water ingestion, and during clinical examinations, such as uroflowmetry, and is seldom observed in ordinary people. Here we report a patient with severe hyponatremia due to voluntary water drinking coexisting with no psychiatric problems. The case presented clinically significant hyponatremia 124 mmol/L without any signs of dehydration after voluntary ingestion of 4000 ml of water over 3 hours. She normally responded to ingestion of 1000 ml of water over 20 min after recovery from hyponatremia, and did not meet the diagnostic criteria of SIADH. She was not a compulsive drinker. The present case suggests that one should consider water intoxication as a cause of hyponatremia in a patient without signs of dehydration, even if he/she does not have a history of compulsive water ingestion.