Reminder of important clinical lesson
Overdrinking-induced hyponatraemia in the 2007 London Marathon
1 University of Gloucestershire, Sport, Health and Social Care, Oxstalls Campus, Oxstalls Lane, Gloucester GL2 9HW, UK
2 London Chest Hospital, Bonner Road, London E2 9JX, UK
3 Sport Science Institute of South Africa, University of Cape Town, Cape Town, 7725, South Africa
Correspondence to:
sdraper{at}glos.ac.uk
We report a case of overdrinking-induced hyponatraemia from the 2007 London Marathon. The patient was a 37-year-old experienced female marathon runner. She was brought to the emergency room more than 6 h after completing the marathon suffering from diarrhoea, vomiting and confusion, and was unable to recall any detail of the race. An arterial blood sample confirmed hyponatraemia ([Na+] 117 mmol.l–1) associated with hypokalaemia (serum potassium concentration 3.4 mmol.l–1) and respiratory alkalosis (pH 7.62, bicarbonate 16.1 mmol.l–1 and PCO2 2.14 kPa). A diagnosis of uncomplicated exercise-associated hyponatraemia due to voluntary overdrinking was made and the patient was catherised and treated with a slow (1 h) intra-venous infusion of 500 ml of 1.8% sodium chloride (NaCl) solution. The following morning her serum [Na+] had normalised at 135 mmol.l–1 and she was discharged in the afternoon. She has recovered fully without sequelae.
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