Beer potomania syndrome: Difference between revisions
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==Background== | ==Background== | ||
*Constellation of [[electrolyte abnormalities]] that occur secondary to overconsumption of electrolyte-poor liquid with little other sources of nutrition (e.g. drinking a lot of beer and not eating much) | |||
*Poor overall electrolyte intake limits formation of normal renal urea gradient-->inability to excrete sufficient free water | |||
*Total body sodium may be depleted, yet still may have elevated urinary sodium/[[FENa]] due to dysfunction of water metabolism | |||
*Attention to proper nutrition during acute illness may obviate need for hypertonic saline | |||
==Clinical Features== | ==Clinical Features== | ||
* | *History of chronic alcohol ingestion (in a hypotonic form like beer) | ||
* | *Protein malnutrition | ||
*[[Seizures]] | *[[Seizures]] | ||
*[[Altered Mental Status]] | *[[Altered Mental Status]] | ||
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**Hypochloremia | **Hypochloremia | ||
**[[Hypokalemia]] | **[[Hypokalemia]] | ||
*No evidence of another cause of | *No evidence of another cause of hyponatremia (such as [[steroid]]] use, [[diuretic]] use, hyperlipidaemia, etc.) | ||
==Management== | ==Management== | ||
*If seizing or other severe symptoms, | *If seizing or other severe symptoms, bolus [[hypertonic saline]] | ||
*Otherwise gentle replacement of electrolytes with close attention paid to diet is important | *Otherwise, gentle replacement of electrolytes with close attention paid to diet is important | ||
==Disposition== | ==Disposition== | ||
Latest revision as of 22:10, 18 October 2023
Background
- Constellation of electrolyte abnormalities that occur secondary to overconsumption of electrolyte-poor liquid with little other sources of nutrition (e.g. drinking a lot of beer and not eating much)
- Poor overall electrolyte intake limits formation of normal renal urea gradient-->inability to excrete sufficient free water
- Total body sodium may be depleted, yet still may have elevated urinary sodium/FENa due to dysfunction of water metabolism
- Attention to proper nutrition during acute illness may obviate need for hypertonic saline
Clinical Features
- History of chronic alcohol ingestion (in a hypotonic form like beer)
- Protein malnutrition
- Seizures
- Altered Mental Status
- Weakness
Differential Diagnosis
- Ethanol toxicity
- Alcohol use disorder
- Alcohol withdrawal
- Electrolyte/acid-base disorder
Evaluation
Work-Up
- Chem 10
- Osmolality
- ADH
Evaluation
- Signs, symptoms and laboratory values consistent with water intoxication
- Hyponatremia
- Hypochloremia
- Hypokalemia
- No evidence of another cause of hyponatremia (such as steroid] use, diuretic use, hyperlipidaemia, etc.)
Management
- If seizing or other severe symptoms, bolus hypertonic saline
- Otherwise, gentle replacement of electrolytes with close attention paid to diet is important
Disposition
Admit patient with:
See Also
References
- Va Med. 1989 Jun;116(6):270-1. Beer potomania syndrome in an alcoholic. Harrow AS.