A Case of Severe Exercise Associated Hyponatremia after Running Marathon

7.2 mmol/L, 85 µmol/L, and 2732 U/L respectively. Urine myoglobin was negative. White cell count was 17 x 10 9 /L, otherwise the complete blood count and liver function tests were normal. Further workup for hyponatremia were performed. Paired plasma osmolality, urine osmolality, and spot urine sodium checked 5 hours later were 244 mmol/Kg, 580 mmol/Kg, and 46 mmol/L respectively. There were no adrenal insufficiency or hypothyroidism. Deaths are with only 14 Abstract Exercise associated hyponatremia (EAH) can cause serious neurological manifestations. We report a case of EAH presented with convulsion and drowsiness after running marathon. The patient’s plasma sodium level on presentation was 119 mmol/L. He was given intravenous hypertonic saline infusion for 2 times. His conscious level improved after hypertonic saline and plasma sodium level corrected. He regained full consciousness 3 days after admission and was discharged in good condition. In this report, we reviewed the underlying pathophysiology, clinical features, risk factors, prevention measures, and treatment options of this disease entity. Early recognition of this disease entity and timely treatment with hypertonic saline is life saving.