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Case report
peer-reviewed

“Beer Potomania” – A Syndrome of Severe Hyponatremia with Unique Pathophysiology: Case Studies and Literature Review



Abstract

Beer potomania, a unique syndrome of hyponatremia, was first reported in 1972. It is described as the excessive intake of alcohol, particularly beer, together with poor dietary solute intake that leads to fatigue, dizziness, and muscular weakness. The low solute content of beer, and suppressive effect of alcohol on proteolysis result in reduced solute delivery to the kidney. The presence of inadequate solute in the kidney eventually causes dilutional hyponatremia secondary to reduced clearance of excess fluid from the body. Early detection of hyponatremia due to beer potomania in the hospital is necessary to carefully manage the patient in order to avoid neurological consequences as this syndrome has unique pathophysiology. We are reporting two cases, presenting to the emergency department with severe hyponatremia. After a detailed initial evaluation of the patients and labs for hyponatremia, a diagnosis of beer potomania was established in both cases. Considering the unique pathophysiology of beer potomania syndrome, the patients were closely monitored and treated appropriately to prevent any neurological sequelae.



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Case report
peer-reviewed

“Beer Potomania” – A Syndrome of Severe Hyponatremia with Unique Pathophysiology: Case Studies and Literature Review


Author Information

Muhammad Uzair Lodhi Corresponding Author

Medical Student, Department of Medicine, Raleigh General Hospital, Beckley, Wv

Tahira Sabeen Saleem

Department of Medicine, Raleigh General Hospital, Beckley, Wv

Aaron R. Kuzel

Department of Emergency Medicine, Lincoln Memorial University-Debusk College of Osteopathic Medicine

Dawood Khan

Internal Medicine, Raleigh General Hospital, Beckley, Wv

Intekhab Askari Syed

Medical Student, Department of Medicine, Beckley Appalachian Regional Healthcare

Medical Student, Raleigh General Hospital, Beckley, Wv

Umar Rahim

Pre-Medical Student, Department of Sciences, Queens University of Charlotte, Nc

Hafiz Imran Iqbal

Nephrologist, Department of Medicine, Raleigh General Hospital, Beckley, Wv

Mustafa Rahim

Assistant Clinical Professor of Internal Medicine, West Virginia University School of Medicine

Adjunct Faculty, Lincoln Memorial University, School of Medicine


Ethics Statement and Conflict of Interest Disclosures

Human subjects: Consent was obtained by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.


Case report
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“Beer Potomania” – A Syndrome of Severe Hyponatremia with Unique Pathophysiology: Case Studies and Literature Review


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Case report
peer-reviewed

“Beer Potomania” – A Syndrome of Severe Hyponatremia with Unique Pathophysiology: Case Studies and Literature Review

  • Author Information
    Muhammad Uzair Lodhi Corresponding Author

    Medical Student, Department of Medicine, Raleigh General Hospital, Beckley, Wv

    Tahira Sabeen Saleem

    Department of Medicine, Raleigh General Hospital, Beckley, Wv

    Aaron R. Kuzel

    Department of Emergency Medicine, Lincoln Memorial University-Debusk College of Osteopathic Medicine

    Dawood Khan

    Internal Medicine, Raleigh General Hospital, Beckley, Wv

    Intekhab Askari Syed

    Medical Student, Department of Medicine, Beckley Appalachian Regional Healthcare

    Medical Student, Raleigh General Hospital, Beckley, Wv

    Umar Rahim

    Pre-Medical Student, Department of Sciences, Queens University of Charlotte, Nc

    Hafiz Imran Iqbal

    Nephrologist, Department of Medicine, Raleigh General Hospital, Beckley, Wv

    Mustafa Rahim

    Assistant Clinical Professor of Internal Medicine, West Virginia University School of Medicine

    Adjunct Faculty, Lincoln Memorial University, School of Medicine


    Ethics Statement and Conflict of Interest Disclosures

    Human subjects: Consent was obtained by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

    Acknowledgements


    Article Information

    Published: December 29, 2017

    DOI

    10.7759/cureus.2000

    Cite this article as:

    Lodhi M, Saleem T, Kuzel A R, et al. (December 29, 2017) “Beer Potomania” – A Syndrome of Severe Hyponatremia with Unique Pathophysiology: Case Studies and Literature Review. Cureus 9(12): e2000. doi:10.7759/cureus.2000

    Publication history

    Received by Cureus: December 03, 2017
    Peer review began: December 13, 2017
    Peer review concluded: December 14, 2017
    Published: December 29, 2017

    Copyright

    © Copyright 2017
    Lodhi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 3.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    License

    This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Beer potomania, a unique syndrome of hyponatremia, was first reported in 1972. It is described as the excessive intake of alcohol, particularly beer, together with poor dietary solute intake that leads to fatigue, dizziness, and muscular weakness. The low solute content of beer, and suppressive effect of alcohol on proteolysis result in reduced solute delivery to the kidney. The presence of inadequate solute in the kidney eventually causes dilutional hyponatremia secondary to reduced clearance of excess fluid from the body. Early detection of hyponatremia due to beer potomania in the hospital is necessary to carefully manage the patient in order to avoid neurological consequences as this syndrome has unique pathophysiology. We are reporting two cases, presenting to the emergency department with severe hyponatremia. After a detailed initial evaluation of the patients and labs for hyponatremia, a diagnosis of beer potomania was established in both cases. Considering the unique pathophysiology of beer potomania syndrome, the patients were closely monitored and treated appropriately to prevent any neurological sequelae.



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Muhammad Uzair Lodhi , Medical Student

Medical Student, Department of Medicine, Raleigh General Hospital, Beckley, Wv

For correspondence:
muhammaduzairlodhi@gmail.com

Tahira Sabeen Saleem

Department of Medicine, Raleigh General Hospital, Beckley, Wv

Aaron R. Kuzel, Medical Student

Department of Emergency Medicine, Lincoln Memorial University-Debusk College of Osteopathic Medicine

Dawood Khan , Medical Student

Internal Medicine, Raleigh General Hospital, Beckley, Wv

Intekhab Askari Syed, Medical Student

Medical Student, Department of Medicine, Beckley Appalachian Regional Healthcare

Umar Rahim, Student

Pre-Medical Student, Department of Sciences, Queens University of Charlotte, Nc

Hafiz Imran Iqbal

Nephrologist, Department of Medicine, Raleigh General Hospital, Beckley, Wv

Mustafa Rahim , M.D.

Assistant Clinical Professor of Internal Medicine, West Virginia University School of Medicine

Muhammad Uzair Lodhi , Medical Student

Medical Student, Department of Medicine, Raleigh General Hospital, Beckley, Wv

For correspondence:
muhammaduzairlodhi@gmail.com

Tahira Sabeen Saleem

Department of Medicine, Raleigh General Hospital, Beckley, Wv

Aaron R. Kuzel, Medical Student

Department of Emergency Medicine, Lincoln Memorial University-Debusk College of Osteopathic Medicine

Dawood Khan , Medical Student

Internal Medicine, Raleigh General Hospital, Beckley, Wv

Intekhab Askari Syed, Medical Student

Medical Student, Department of Medicine, Beckley Appalachian Regional Healthcare

Umar Rahim, Student

Pre-Medical Student, Department of Sciences, Queens University of Charlotte, Nc

Hafiz Imran Iqbal

Nephrologist, Department of Medicine, Raleigh General Hospital, Beckley, Wv

Mustafa Rahim , M.D.

Assistant Clinical Professor of Internal Medicine, West Virginia University School of Medicine