• Moeko Kubo, Ichiro Horie, Jun-Ichi Tokumitsu, Hideyuki Tsuchiyama, Erika Nakaji, Keiko Naganobu, Haruka Arimori, Ai Haraguchi, Toshiyuki Ikeoka, and Atsushi Kawakami.
• Department of Diabetes and Endocrinology, Isahaya General Hospital, Japan Community Health Care Organization, Japan.
• Intern. Med. 2024 Aug 1.

AbstractExercise-associated hyponatremia (EAH) is a life-threatening dilutional hyponatremia that typically occurs during or immediately after exercise in endurance athletes. A 49-year-old actress experienced dizziness 15 min after a 2-h stage performance while drinking several bottles of water. Thirty minutes later, the patient fell unconscious and was hospitalized. On admission, she showed dilutional hyponatremia (117 mmol/L) with extremely elevated arginine vasopressin (11.3 pg/mL). After initial treatment with 3% saline, her sodium levels immediately increased, and she recovered consciousness without developing subsequent osmotic demyelination syndrome. This case emphasizes the need for caution against excessive fluid intake during and/or after exercise to avoid EAH, even in non-athletes.

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