Description

An alcoholic who drinks a large quantity of bee or hard cider in a short period is at risk of developing hyponatremia. Beer is hypo-osmolar and it may be difficult for the kidneys to excrete the excess free water (so be sure to eat those salty snacks).


 

Clinical features:

(1) ingestion of a large amount of beer and/or hard cider in a short period of time, often during a binge period

(2) history of poor dietary intake with protein malnutrition

(3) marked hyponatremia

(4) very dilute urine (low urine osmolarity)

(5) hypokalemia and hypochloremia

 

Complications:

(1) central pontine myelinolysis (especially if the hyponatremia is corrected quickly)

(2) hyponatremic encephalopathy

(3) seizures

 

Differential diagnosis:

(1) other causes of hyponatremia in alcoholics

(2) alcohol withdrawal

(3) other toxic ingestions

 


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