{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T15:10:01Z","timestamp":1745593801893,"version":"3.40.4"},"reference-count":15,"publisher":"BMJ","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ Case Reports"],"published-print":{"date-parts":[[2009]]},"abstract":"<jats:p>We report a case of overdrinking-induced hyponatraemia from the 2007 London Marathon. The patient was a 37-year-old experienced female marathon runner. She was brought to the emergency room more than 6 h after completing the marathon suffering from diarrhoea, vomiting and confusion, and was unable to recall any detail of the race. An arterial blood sample confirmed hyponatraemia ([Na<jats:sup>+<\/jats:sup>] 117 mmol.l<jats:sup>\u22121<\/jats:sup>) associated with hypokalaemia (serum potassium concentration 3.4 mmol.l<jats:sup>\u22121<\/jats:sup>) and respiratory alkalosis (pH 7.62, bicarbonate 16.1 mmol.l<jats:sup>\u22121<\/jats:sup>and P<jats:sc>co<\/jats:sc><jats:sub>2<\/jats:sub>2.14 kPa). A diagnosis of uncomplicated exercise-associated hyponatraemia due to voluntary overdrinking was made and the patient was catherised and treated with a slow (1 h) intra-venous infusion of 500 ml of 1.8% sodium chloride (NaCl) solution. The following morning her serum [Na<jats:sup>+<\/jats:sup>] had normalised at 135 mmol.l<jats:sup>\u22121<\/jats:sup>and she was discharged in the afternoon. She has recovered fully without sequelae.<\/jats:p>","DOI":"10.1136\/bcr.09.2008.1002","type":"journal-article","created":{"date-parts":[[2009,3,27]],"date-time":"2009-03-27T10:13:03Z","timestamp":1238148783000},"page":"bcr0920081002","source":"Crossref","is-referenced-by-count":6,"title":["Overdrinking-induced hyponatraemia in the 2007 London Marathon"],"prefix":"10.1136","volume":"2009","author":[{"given":"Stephen B","family":"Draper","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kate J","family":"Mori","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Lloyd-Owen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy","family":"Noakes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2009,3,27]]},"reference":[{"key":"2025042507421691000_2009.mar26_1.bcr0920081002.1","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1249\/00005768-198506000-00012","article-title":"Water intoxication: a possible complication during endurance exercise","volume":"17","author":"Noakes","year":"1985","journal-title":"Med Sci Sports Exerc"},{"key":"2025042507421691000_2009.mar26_1.bcr0920081002.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa043901"},{"key":"2025042507421691000_2009.mar26_1.bcr0920081002.3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200504143521526"},{"key":"2025042507421691000_2009.mar26_1.bcr0920081002.4","doi-asserted-by":"crossref","first-page":"711","DOI":"10.7326\/0003-4819-132-9-200005020-00005","article-title":"Hyponatremia, cerebral edema, and noncardiogenic pulmonary edema in marathon runners","volume":"132","author":"Ayus","year":"2000","journal-title":"Ann Intern Med"},{"key":"2025042507421691000_2009.mar26_1.bcr0920081002.5","doi-asserted-by":"publisher","DOI":"10.1097\/01.jsm.0000174702.23983.41"},{"key":"2025042507421691000_2009.mar26_1.bcr0920081002.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2006.10.027"},{"key":"2025042507421691000_2009.mar26_1.bcr0920081002.7","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7407.113"},{"key":"2025042507421691000_2009.mar26_1.bcr0920081002.8","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2005.020354"},{"key":"2025042507421691000_2009.mar26_1.bcr0920081002.9","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1152\/jappl.1991.70.1.342","article-title":"Evaluation of renal function and fluid homeostasis during recovery from exercise-induced hyponatremia","volume":"70","author":"Irving","year":"1991","journal-title":"J Appl Physiol"},{"key":"2025042507421691000_2009.mar26_1.bcr0920081002.10","unstructured":"water Marathon victim died from drinking too MUCH . Daily Mail, 24 April 2007. Available from: http:\/\/www.dailymail.co.uk\/pages\/live\/articles\/news\/news.html?in_article_id=450341&in_page_id=1770&in_page_id=1770&expand=true#StartComments (accessed 17 February 2009)."},{"key":"2025042507421691000_2009.mar26_1.bcr0920081002.11","first-page":"131S","article-title":"Hyponatremic encephalopathy in a marathon runner","volume":"124","author":"Thomson","year":"2003","journal-title":"Chest"},{"key":"2025042507421691000_2009.mar26_1.bcr0920081002.12","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.0509096102"},{"key":"2025042507421691000_2009.mar26_1.bcr0920081002.13","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1097\/00042752-199504000-00009","article-title":"Dehydration during exercise: what are the real dangers?","volume":"5","author":"Noakes","year":"1995","journal-title":"Clin J Sport Med"},{"key":"2025042507421691000_2009.mar26_1.bcr0920081002.14","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1093\/milmed\/164.3.234","article-title":"Death from hyponatremia as a result of acute water intoxication in an army basic trainee","volume":"164","author":"Garigan","year":"1999","journal-title":"Mil Med"},{"key":"2025042507421691000_2009.mar26_1.bcr0920081002.15","doi-asserted-by":"publisher","DOI":"10.2165\/00007256-200737040-00049"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr.09.2008.1002","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T14:42:26Z","timestamp":1745592146000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr.09.2008.1002"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009]]},"references-count":15,"alternative-id":["10.1136\/bcr.09.2008.1002"],"URL":"https:\/\/doi.org\/10.1136\/bcr.09.2008.1002","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2009]]}}}