Considering exercise-associated hyponatraemia as a continuum

BMJ Case Rep. 2018 Mar 9:2018:bcr2017222916. doi: 10.1136/bcr-2017-222916.

Abstract

Exercise-associated hyponatraemia (EAH) always involves a component of overhydration relative to available exchangeable sodium stores. In the majority of cases, this is purely due to excessive consumption of fluids during exercise. In a lesser number of cases, it is apparent that excessive sodium loss through sweat may play a role by decreasing the amount of acutely available exchangeable sodium. Two cases demonstrating the latter, one in an individual with cystic fibrosis (CF) and another in an endurance athlete without CF, demonstrate how elevated dermal sweat losses may contribute to a relative dilutional EAH along a pathophysiological continuum.

Keywords: cystic fibrosis; fluid electrolyte and acid-base disturbances; general practice / family mMedicine; sports and exercise medicine.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aftercare
  • Anticonvulsants / therapeutic use
  • Antidiuretic Agents / therapeutic use
  • Confusion / diagnosis
  • Confusion / etiology
  • Cystic Fibrosis / diagnosis
  • Cystic Fibrosis / metabolism*
  • Deamino Arginine Vasopressin / administration & dosage
  • Deamino Arginine Vasopressin / therapeutic use
  • Diagnosis, Differential
  • Exercise / physiology*
  • Female
  • Heat Exhaustion / diagnosis
  • Hospitalization
  • Humans
  • Hyponatremia / diagnosis
  • Hyponatremia / physiopathology*
  • Iontophoresis / methods
  • Lorazepam / administration & dosage
  • Lorazepam / therapeutic use
  • Male
  • Nausea / diagnosis
  • Nausea / etiology
  • Osmolar Concentration
  • Seizures / diagnosis
  • Seizures / drug therapy
  • Sodium / analysis*
  • Sodium / blood
  • Sweat / metabolism*
  • Treatment Outcome

Substances

  • Anticonvulsants
  • Antidiuretic Agents
  • Sodium
  • Deamino Arginine Vasopressin
  • Lorazepam