Document Detail

Fatal voluntary salt intake resulting in the highest ever documented sodium plasma level in adults (255 mmol L-1): a disorder linked to female gender and psychiatric disorders.
MedLine Citation:
PMID:  15554954     Owner:  NLM     Status:  MEDLINE    
Excessive ingestion of salt is a well-recognized cause of hypernatraemia in children, is uncommonly recognized in debilitated elderly persons, but is rarely diagnosed in healthy, independent adults. We report a case of fatal salt poisoning in a 20-year-old lady who suffered of post-natal depression and ingested large quantities of salt as part of exorcism ritual. She presented with the highest ever documented serum sodium level of 255 mmol L(-1), associated with severe neurological impairment that was unresponsive to aggressive hypotonic fluid replacement. Post-mortem examination ruled out any other possible probable cause of death. The medical literature was reviewed, and 16 previous cases of severe hypernatraemia in adults secondary to excessive salt ingestion were retrieved. Common features of all reported cases included female gender (95% of cases) and evidence of underlying cognitive or psychiatric disorders (all reported cases). We conclude that women with documented cognitive or psychiatric disorders, in particular depression, are susceptible for psychogenic salt poisoning. Awareness should be raised to the potentially life-risking use of salty beverages as emetics or as part of 'exorcism' rituals.
Y Ofran; D Lavi; D Opher; T A Weiss; E Elinav
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Journal of internal medicine     Volume:  256     ISSN:  0954-6820     ISO Abbreviation:  J. Intern. Med.     Publication Date:  2004 Dec 
Date Detail:
Created Date:  2004-11-23     Completed Date:  2004-12-21     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  8904841     Medline TA:  J Intern Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  525-8     Citation Subset:  IM    
Department of Medicine, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
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MeSH Terms
Ceremonial Behavior*
Critical Care / methods
Depression, Postpartum / psychology*
Fatal Outcome
Hypernatremia / chemically induced
Sex Factors
Sodium Chloride / poisoning*
Treatment Failure
Reg. No./Substance:
7647-14-5/Sodium Chloride

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