Behavioural induced severe hypernatremia without neurological manifestations

Area of Science:

• Internal Medicine
• Nephrology
• Emergency Medicine

Background:

• Hypernatremia, characterized by elevated serum sodium, is common in the elderly and critically ill.
• Severe cases often present with central nervous system manifestations and high mortality rates.
• Etiologies of hypernatremia differ significantly between pediatric and adult populations.

Observation:

• A female patient presented with severe hypernatremia without co-morbidities or neurological symptoms.
• The patient was admitted to King Khalid University Hospital, Riyadh, Saudi Arabia.
• Extensive evaluations failed to reveal an underlying medical condition.

Findings:

• The primary cause identified was underhydration due to reduced fluid intake.
• This reduced intake was attributed to behavioral factors.
• No other etiological background was found despite thorough investigation.

Implications:

• This case underscores the importance of considering behavioral causes for dehydration leading to hypernatremia.
• It highlights that severe hypernatremia can occur in individuals without predisposing medical conditions.
• Behavioral assessment should be considered in unexplained hypernatremia cases, particularly in the absence of neurological signs.