Psychogenic adipsia presenting as recurrent functional vomiting and hypernatremia

Abstract

Hypernatremia is caused by a disproportionate balance of inadequate free water relative to sodium level. Frequent causes of hypernatremia include renal or gastrointestinal fluid loss, hypothalamic injury, and endocrine abnormalities. The authors describe a rare case of hypernatremia that manifested secondary to psychogenic adipsia in a 46-year-old woman presenting with intractable vomit-ing. Her presenting symptoms and laboratory abnormalities resolved after treatment was initiated for major depression. This case highlights the need for a holistic approach when confronted with a case of unexplained hypernatremia.