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Clinical Pediatrics
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Severe Hypernatremia and Hyperosmolality Exacerbated by an Herbal Preparation in a Patient With Diabetic Ketoacidosis

Samar K. Bhowmick, MD, FACE

Division of Pediatric Endocrinology, University of South Alabama Medical Center, Mobile, Alabama, sbhowmick{at}usouthal.edu

Olivette T. Hundley, MD

Division of Pediatric Endocrinology, University of South Alabama Medical Center, Mobile, Alabama

Kenneth R. Rettig, MD

Division of Pediatric Endocrinology, University of South Alabama Medical Center, Mobile, Alabama

This article reports a case of severe reversible hypernatremia exacerbated by an herbal agent "goldenseal" (Hydrastis canadensis) in an 11-year-old girl with new onset type I diabetes mellitus presented with diabetic ketoacidosis. A literature review is presented and possible mechanism of hypernatremia caused by this herbal preparation is discussed.

Key Words: diabetic ketoacidosis • hypernatremia • hyperosmolar hyperglycemic state • glutamic acid decarboxylase • islet cell antibody

This version was published on December 1, 2007

Clinical Pediatrics, Vol. 46, No. 9, 831-834 (2007)
DOI: 10.1177/0009922807303042
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