Raphaël J C, Tétard C, Thibonnier M, Goulon M
Ann Med Interne (Paris). 1980;131(5):297-301.
Severe water and electrolyte disturbances were observed in a patient after a bout of very heavy beer drinking (30 liters in 6 days). On admission she was found to have hypokalemia (2.2 mEq/I), metabolic alkalosis (pHa: 7.55-total CO2: 40 mEq/I), and more particularly hyponatremia (109 mEq/I), responsible for the typical neurological signs of water intoxication (hyponatremic encephalopathy). There was a positive cumulative return of sodium (570 mEq) and chloride (900 mEq) levels, and normal conditions were restored without significant modifications in water balance or weight. No other etiology, apart from the beer, was discovered. Heavy drinking of beer alone can therefore provoke chloride and sodium depletion, probably because beer, which is poor in NaCl, must produce urinary loss of these electrolytes. The high osmolarity of beer may explain this latter phenomenon. This particular cause of hyponatremia should be recognized, if only to avoid confusing the clinical signs of alcoholic intoxication with those due to water intoxication.
一名患者在大量饮用啤酒（6天内饮用30升）后出现严重的水和电解质紊乱。入院时发现她患有低钾血症（2.2 mEq/I）、代谢性碱中毒（动脉血pH值：7.55 - 总二氧化碳：40 mEq/I），更具体地说是低钠血症（109 mEq/I），这导致了水中毒的典型神经症状（低钠性脑病）。钠（570 mEq）和氯（900 mEq）水平呈阳性累积恢复，在水平衡或体重无显著变化的情况下恢复了正常状态。除了啤酒外，未发现其他病因。因此，仅大量饮用啤酒就可能导致氯和钠的消耗，可能是因为啤酒中氯化钠含量低，必然会导致这些电解质的尿液流失。啤酒的高渗透压可能解释了后一种现象。这种低钠血症的特殊病因应该被认识到，哪怕只是为了避免将酒精中毒的临床症状与水中毒的症状相混淆。
