Articles: soy-foods-poisoning.
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Rapid-onset, acute hypernatremia caused by sodium overload is a rare, life-threatening condition. Although experts recommend rapid correction of sodium concentration [Na] based on pathophysiological theories, only a few reports have documented the specific details of sodium correction methods. The objective of this study was to systematically review the reported treatment regimens, achieved [Na] correction rates, and treatment outcomes. ⋯ The limited empirical evidence derived from case reports appears to endorse the recommended, rapid, and aggressive sodium correction using dextrose-based hypotonic solutions.
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Intentional massive sodium chloride ingestions are rare occurrences and are often fatal. ⋯ Emergency physicians should consider rapidly lowering serum sodium with hypotonic intravenous fluids as a potential management strategy for acute severe hypernatremia secondary to massive salt ingestion.
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We report a case of fatal salt poisoning in a 55-year-old woman who suffered from depression and drank a large quantity of shoyu (Japanese soy sauce). She presented with the highest ever documented serum sodium level of 187 mmol/L. ⋯ She died as a result of massive pulmonary edema, despite intensive medical treatment. Viewing the results of clinical and postmortem investigations together, her death could clearly be attributed to drinking a large quantity of soy sauce.
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Fatal hypernatremia due to soy sauce ingestion is rare. We describe a 65-year-old woman who became unresponsive after ingesting 1150 ml of soy sauce. ⋯ She was treated successfully with acute hemodialysis and her serum sodium concentration decreased to 146 mEq/l without any significant neurologic complication. We recommend hemodialysis is the best approach to correct severe hypernatremia.