title: Symptomatic hyponatremia after voluntary excessive water ingestion in a patient without psychiatric problems.
abstract: 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.
authors.affiliation: Toranomon Hospital Endocrine Center, 2-2-2 Toranomo Minato-ku, Tokyo 105-8470, Japan.
authors.forename: Rikako
authors.initials: R
authors.lastname: Hiramatsu
authors.forename: Akira
authors.initials: A
authors.lastname: Takeshita
authors.forename: Manabu
authors.initials: M
authors.lastname: Taguchi
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Takeuchi
mesh_terms: D004327:Drinking Behavior; D005260:Female; D006801:Humans; D007010:Hyponatremia / Q000209:etiology* / Q000523:psychology; D008603:Mental Health; D008875:Middle Aged; D014869:Water Intoxication / Q000150:complications* / Q000523:psychology