Exercise-associated Hyponatremia Developing Immediately after a Musical Stage Performance in a Healthy Actress

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  • Kubo Moeko
    Department of Diabetes and Endocrinology, Isahaya General Hospital, Japan Community Health Care Organization, Japan Department of Endocrinology and Metabolism, Nagasaki University Hospital, Japan
  • Horie Ichiro
    Department of Endocrinology and Metabolism, Nagasaki University Hospital, Japan
  • Tokumitsu Jun-ichi
    Department of Diabetes and Endocrinology, Isahaya General Hospital, Japan Community Health Care Organization, Japan
  • Tsuchiyama Hideyuki
    Department of Diabetes and Endocrinology, Isahaya General Hospital, Japan Community Health Care Organization, Japan Department of Endocrinology and Metabolism, Nagasaki University Hospital, Japan
  • Nakaji Erika
    Department of Diabetes and Endocrinology, Isahaya General Hospital, Japan Community Health Care Organization, Japan Department of Endocrinology and Metabolism, Nagasaki University Hospital, Japan
  • Naganobu Keiko
    Department of Diabetes and Endocrinology, Isahaya General Hospital, Japan Community Health Care Organization, Japan
  • Arimori Haruka
    Department of Diabetes and Endocrinology, Isahaya General Hospital, Japan Community Health Care Organization, Japan Department of Endocrinology and Metabolism, Nagasaki University Hospital, Japan
  • Haraguchi Ai
    Department of Endocrinology and Metabolism, Nagasaki University Hospital, Japan
  • Ikeoka Toshiyuki
    Department of Endocrinology and Metabolism, Nagasaki University Hospital, Japan
  • Kawakami Atsushi
    Department of Endocrinology and Metabolism, Nagasaki University Hospital, Japan

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<p>Exercise-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. </p>

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  • Internal Medicine

    Internal Medicine 64 (5), 735-740, 2025-03-01

    The Japanese Society of Internal Medicine

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