title: Severe Hypernatremia Caused by Acute Exogenous Salt Intake Combined with Primary Hypothyroidism.
abstract: This report describes a case of severe hypernatremia with a serum sodium concentration of 188.1mmol/L caused by exogenous salt intake. A 26-year-old man diagnosed with Crohn's disease 5 years previously visited our clinic due to generalized edema and personality changes, with aggressive behavior. He had compulsively consumed salts, ingesting approximately 154 g of salt over the last 4 days. Despite careful fluid management that included not only hypotonic fluid therapy for 8 hours but also hypertonic saline administration, his serum sodium level decreased sharply at 40.6 mmol/L; however, it returned to normal within 72-hour of treatment without any neurological deficits. Primary hypothyroidism was also diagnosed. He was discharged after 9 days from admission, with a stable serum sodium level. We have described the possibility of successful treatment in a patient with hypernatremia caused by acute salt intoxication without sustained hypotonic fluid therapy.
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Woo Jin
authors.initials: WJ
authors.lastname: Jung
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Su Min
authors.initials: SM
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Jong Man
authors.initials: JM
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.; Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
authors.forename: Harin
authors.initials: H
authors.lastname: Rhee
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Il Young
authors.initials: IY
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Dong Won
authors.initials: DW
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Soo Bong
authors.initials: SB
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.; Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
authors.forename: Eun Young
authors.initials: EY
authors.lastname: Seong
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.; Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
authors.forename: Ihm Soo
authors.initials: IS
authors.lastname: Kwak
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.; Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
authors.forename: Sang Heon
authors.initials: SH
authors.lastname: Song
keywords: Crohn's disease; Hypernatremia; Primary hypothyroidism; Salt