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Abstract
Background: Hyponatremia is the most frequent electrolyte disorder. However, hyponatremia
rarely results from excessive water intake, unless the kidney is unable to excrete
free water, such as in patients on thiazide diuretics; in addition, hyponatremia is
an uncommon cause of rhabdomyolysis. Methods: We present a 51-year-old hypertensive
woman on chronic hydrochlorothiazide therapy who developed acute water intoxication
and severe myalgias. Results: The patient developed acute hypotonic hyponatremia
and subsequent rhabdomyolysis. We discuss the mechanisms responsible for the development
of hyponatremia and its association with rhabdomyolysis. Conclusion: Muscle enzymes
should be monitored in patients with acute hyponatremia who develop muscle pain, and
hyponatremia-induced rhabdomyolysis must be considered in patients with myalgias receiving
thiazide diuretics.