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Case series: hyponatremia associated with moderate exercise
J Zelingher1, C Putterman, Y Ilan
1Division of Internal Medicine, Hadassah University Hospital-Ein Kerem, Jerusalem, Israel.
The American Journal of the Medical Sciences
|February 1, 1996
Summary
Life-threatening exercise-induced hyponatremia can occur during moderate exercise, not just extreme endurance sports. This condition can cause severe neurological symptoms like confusion and seizures, even in non-athletes.
Area of Science:
- Sports Medicine
- Endocrinology
- Neurology
Background:
- Exercise-induced hyponatremia is typically associated with extreme physical exertion.
- Previous literature has not described cases of hyponatremia complicating moderate exercise.
Observation:
- Seven patients presented with life-threatening hyponatremia after mild to moderate exercise.
- Symptoms included nausea, vomiting, agitation, confusion, and seizures in five patients.
- Laboratory findings revealed severe hyponatremia (as low as 115 mEq/L) with high urine sodium and elevated serum creatine kinase.
Findings:
- Moderate exercise can precipitate severe exercise-induced hyponatremia.
- Neurologic manifestations, including seizures, can be a consequence of exercise-induced hyponatremia.
- The underlying mechanism may involve inappropriate antidiuretic hormone secretion.
Implications:
- Clinicians should consider exercise-induced hyponatremia in patients presenting with neurological symptoms after moderate physical activity.
- This finding broadens the understanding of exercise-induced hyponatremia beyond endurance athletes.
- Further research is needed to elucidate the precise mechanisms and develop preventative strategies.