{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:02:29Z","timestamp":1772323349587,"version":"3.50.1"},"reference-count":27,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2004,11,19]],"date-time":"2004-11-19T00:00:00Z","timestamp":1100822400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Internal Medicine"],"published-print":{"date-parts":[[2004,12]]},"abstract":"<jats:p><jats:bold>Abstract.\u2002<\/jats:bold> Ofran Y, Lavi D, Opher D, Weiss TA, Elinav E (Hadassah University Hospital, Jerusalem, Israel). Fatal voluntary salt intake resulting in the highest ever documented sodium plasma level in adults (255\u2003mmol\u2003L<jats:sup>\u22121<\/jats:sup>): a disorder linked to female gender and psychiatric disorders (Case Report). <jats:italic>J Intern Med<\/jats:italic> 2004; <jats:bold>256<\/jats:bold>: 525\u2013528.<\/jats:p><jats:p>Excessive ingestion of salt is a well\u2010recognized 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\u2010year\u2010old lady who suffered of post\u2010natal depression and ingested large quantities of salt as part of exorcism ritual. She presented with the highest ever documented serum sodium level of 255\u2003mmol\u2003L<jats:sup>\u22121<\/jats:sup>, associated with severe neurological impairment that was unresponsive to aggressive hypotonic fluid replacement. Post\u2010mortem 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\u2010risking use of salty beverages as emetics or as part of \u2018exorcism\u2019 rituals.<\/jats:p>","DOI":"10.1111\/j.1365-2796.2004.01411.x","type":"journal-article","created":{"date-parts":[[2004,11,19]],"date-time":"2004-11-19T14:41:15Z","timestamp":1100875275000},"page":"525-528","source":"Crossref","is-referenced-by-count":39,"title":["Fatal voluntary salt intake resulting in the highest ever documented sodium plasma level in adults (255\u2003mmol\u2003L<sup>\u22121<\/sup>): a disorder linked to female gender and psychiatric disorders"],"prefix":"10.1111","volume":"256","author":[{"given":"Y.","family":"Ofran","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Lavi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Opher","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T. A.","family":"Weiss","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Elinav","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2004,11,19]]},"reference":[{"key":"e_1_2_5_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1963.03700160063009"},{"key":"e_1_2_5_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM196403192701208"},{"key":"e_1_2_5_4_2","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.1969.tb62358.x"},{"key":"e_1_2_5_5_2","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.1971.tb87695.x"},{"key":"e_1_2_5_6_2","first-page":"889","article-title":"Fatal poisoning from salt used as an emetic","volume":"125","author":"Barer J","year":"1973","journal-title":"Am J Dis Child"},{"key":"e_1_2_5_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.1.6013.793"},{"key":"e_1_2_5_8_2","first-page":"341","article-title":"Salt poisoning: presenting symptom of child abuse","volume":"21","author":"Feldman K","year":"1979","journal-title":"Vet Hum Toxicol"},{"key":"e_1_2_5_9_2","first-page":"686","volume-title":"Harrison's \u2013 Principles of Internal Medicine","author":"Thorn GW","year":"1977"},{"key":"e_1_2_5_10_2","first-page":"141","article-title":"Fatal ingestion of table salt by an adult","volume":"126","author":"Johnston JG","year":"1977","journal-title":"West J Med"},{"key":"e_1_2_5_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/0006-3223(87)90108-9"},{"key":"e_1_2_5_12_2","first-page":"82","article-title":"Fatal ingestion of sodium hypochlorite bleach with associated hypernatremia and hyperchloremic metabolic acidosis","volume":"41","author":"Ross MP","year":"1999","journal-title":"Vet Hum Toxicol"},{"key":"e_1_2_5_13_2","first-page":"430","article-title":"Severe hypernatremia from sea water ingestion during near\u2010drowning in a hurricane","volume":"167","author":"Ellis RJ.","year":"1997","journal-title":"West J Med"},{"key":"e_1_2_5_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0379-0738(98)00179-0"},{"key":"e_1_2_5_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(85)90483-8"},{"key":"e_1_2_5_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01316579"},{"key":"e_1_2_5_17_2","first-page":"864","article-title":"Accidental salt poisoning","volume":"95","author":"Hey A","year":"1982","journal-title":"New Z Med J"},{"key":"e_1_2_5_18_2","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.1969.tb62358.x"},{"key":"e_1_2_5_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(71)80416-X"},{"key":"e_1_2_5_20_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.3.5934.802-a"},{"key":"e_1_2_5_21_2","first-page":"103","article-title":"Danger of saline emetic in first\u2010aid for poisoning","volume":"4","author":"Bird CA","year":"1974","journal-title":"BMJ"},{"key":"e_1_2_5_22_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.152.3.640"},{"key":"e_1_2_5_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/0379-0738(82)90111-6"},{"key":"e_1_2_5_24_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.4.5993.386"},{"key":"e_1_2_5_25_2","doi-asserted-by":"publisher","DOI":"10.1136\/pgmj.50.586.513"},{"key":"e_1_2_5_26_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000441-199012000-00012"},{"key":"e_1_2_5_27_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.152.3.640"},{"key":"e_1_2_5_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0025-6196(12)62194-6"}],"container-title":["Journal of Internal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1365-2796.2004.01411.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1365-2796.2004.01411.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,13]],"date-time":"2023-10-13T04:25:02Z","timestamp":1697171102000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1365-2796.2004.01411.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2004,11,19]]},"references-count":27,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2004,12]]}},"alternative-id":["10.1111\/j.1365-2796.2004.01411.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1365-2796.2004.01411.x","archive":["Portico"],"relation":{},"ISSN":["0954-6820","1365-2796"],"issn-type":[{"value":"0954-6820","type":"print"},{"value":"1365-2796","type":"electronic"}],"subject":[],"published":{"date-parts":[[2004,11,19]]}}}