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Sodium bicarbonate abuse: a case report.

S M Linford, H D James

    The British Journal of Psychiatry : the Journal of Mental Science
    |October 1, 1986
    PubMed
    Summary
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    Sodium bicarbonate abuse is rare but can cause recurrent hypokalemic metabolic alkalosis. This case highlights a patient with Munchausen syndrome who intentionally misused sodium bicarbonate for hospital admissions.

    Area of Science:

    • Nephrology
    • Endocrinology
    • Psychiatry

    Background:

    • Recurrent hypokalemic metabolic alkalosis is a challenging clinical presentation.
    • Sodium bicarbonate abuse is an uncommon cause of electrolyte disturbances.

    Observation:

    • A patient presented with persistent hypokalemic metabolic alkalosis after extensive investigation.
    • The patient had a history of abusing sodium bicarbonate for eight years.
    • The patient exhibited features consistent with Munchausen syndrome.

    Findings:

    • Prolonged sodium bicarbonate abuse was identified as the cause of the patient's metabolic alkalosis.
    • The patient used intentional overdose of sodium bicarbonate to seek hospital admission.
    • Co-existing Munchausen syndrome explained the patient's behavior.

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    Implications:

    • This case underscores the importance of considering unusual causes of metabolic alkalosis.
    • Awareness of sodium bicarbonate abuse is crucial for clinicians managing electrolyte disorders.
    • The interplay between substance abuse and psychiatric conditions like Munchausen syndrome requires integrated management.