| Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access |
| Article copyright, the authors; Journal compilation copyright, J Med Cases and Elmer Press Inc |
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Case Report
Volume 14, Number 7, July 2023, pages 232-236
Extreme Hypernatremia due to Dehydration
Tables
| Normal range | On admission | 24 h | 48 h | 72 h | 96 h | |
|---|---|---|---|---|---|---|
| BUN: blood urea nitrogen. | ||||||
| Sodium (mmol/L) | 136 - 145 | 191 | 182 | 171 | 164 | 157 |
| Potassium (mmol/L) | 3.5 - 5.1 | 5.1 | 3.9 | 3.5 | 3.1 | 3.3 |
| Chloride (mmol/L) | 98 - 107 | > 150 | > 150 | 146 | 137 | 128 |
| CO2, venous, mmol/L | 22 - 30 | 18 | 17 | 15 | 21 | 19 |
| Anion gap (mmol/L) | < 18 | < 23 | < 17 | 10 | 6 | 10 |
| Glucose (mg/dL) | 70 - 99 | 162 | 236 | 204 | 155 | 97 |
| BUN (mg/dL) | 8 - 26 | 119 | 31 | 31 | 44 | 27 |
| Creatinine (mg/dL) | 0.7 - 1.3 | 3.17 | 2.9 | 2.27 | 1.43 | 1.13 |
| Albumin (g/dL) | 3.5 - 5 | 3.5 | 2.7 | 2.6 | 2.2 | 2.3 |
| Author/year | Patient’s age (years) | Etiology | Na+ level |
|---|---|---|---|
| DM: diabetes mellitus; HD: hemodialysis. | |||
| Ofran et al, 2004 [8] | 20 | Exorcism (use of salt solution) | 255 mmol/L |
| Metheny et al, 2020 [9] | 34 | Salt solution was used as anti-emetic | 196 mmol/L |
| Turk et al, 2005 [10] | 69 | Salt solution given as anti-emetic | 175 mmol/L |
| Furukawa et al, 2011 [11] | 55 | Intentional ingestion of depressed patient by drinking 700 mL of Japanese soy sauce (shoyu) | 187 mmol/L |
| Yamazaki et al, 2000 [12] | 60 | Intentional ingestion of psychotic patient by drinking 1 L bottle of shoyu | Estimated at more than 177 mmol/L at the time of death |
| Carlberg et al, 2013 [13] | 19 | College prank, ingesting a quart of soy sauce | 182 mmol/L |
| Xiao et al, 2019 [14] | 58 | Undiagnosed DM | 191 mmol/L, corrected 202 mmol/L |
| Ju et al, 2013 [15] | 20 | Self-administered to lose weight and improve digestion | 174 mmol/L |
| Moder et al, 1990 [16] | 41 | Ingestion of supersaturated salt water solution intended for gargling | 209 mmol/L |
| Mohtadi et al, 2015 [17] | 33 | Emetic (self) | 175 mmol/L |
| Machino et al, 2006 [18] | 73 | Suicide | 188 mmol/L |
| Nur et al, 2014 [19] | 85 | Dehydration due to poor oral intake (dementia) | 187 mmol/L |
| Choi et al, 2013 [20] | 40 | Paranoid adipsia | 172 mmol/L |
| Bhosle et al, 2015 [21] | 54 | Iatrogenic from wrong bicarb concentration during HD | 207 mmol/L |