Introduction: Disorder in drinking, fluid deprivation, severe disabilities, increase in water excretion from kidney and non-kidney route and increase in salt consumption are the main causes of Hypernatremia. The objective of this study was to determine ocular signs due to Hypernatremia Method: 50 male Wistar rats, weighing 250 + 20 g were allocated randomly to 5 groups. Test groups consumed 2, 3, 3.5 and 4 percent salt concentrations respectively as potable water, control group used tap water; with similar living conditions for all groups. Ophthalmic examinations with slit-lamp and fundus camera were performed. Eye response to light and manuel stimuli was considered. This experiment with similar condition was done on pig and rabbit.Result: Short time using of 2% salt solution was not associated with fast and significant ocular changes but its prolonged use accompanied with vascular damage and other ocular signs. Retinal and vitreous hemorrhages were observed 3-4 days after drinking 3% and higher salt solutions followed by an increase in serum sodium level. Other ocular signs in test groups include: vitreous shrinkage, cornea and lens opacities, swelling of optic disc, blindness, vitreous collapse and finally phthisis bulbi.Conclusion: By Hypernatremia and hyperosmolarity formation, vitreous lose some of its fluid contents and vitreous shrinkage lead to vascular damage, retinal and vitreous hemorrhage, and retinal detachment.Continuous Hypernatremia brought conjunctivitis, corneal and lens opacities, swelling of optic disc, blindness, vitreous collapse and finally phthisis bulbi.

Introduction: Ichthyosis is an epidermal disruption that increases insensible water loss. Hypernatremic dehydration is a consequence of skin disruption. This study reviewed the treatment of hypernatremic dehydration in patients with ichthyosis comparing to patients with intact skin. Case Presentation: We studied five neonates with Hypernatremia, including three ichthyosis cases and two normal-skin neonates. This case-series study showed that the sodium correction rate is slower in infants with ichthyosis than in infants with normal skin. The first and second neonates needed less sodium than fluid intake than normal skin infants, although fluid requirement was lower in the third ichthyosis infant than in others due to less skin disruption in this infant. Conclusions: Fluid therapy in hypernatremic dehydration in ichthyosis patients is different from neonates with intact skin because of excessive insensible water loss in these patients. It may be needed to give more fluid and less sodium depending on the degree of skin disruption, which may not be determined by physical examination.

Introduction: This study aimed to assess the incidence of breastfeeding-associated Hypernatremia and related risk factors among hospitalized hyperbilirubinemic neonates.Methods: This prospective study was conducted at Nemazee Hospital affiliated to Shiraz University of Medical Sciences during one year to determine the association between Hypernatremia (serum sodium concentration of>150 mEq/L) and exclusive breastfeeding of the neonates. During the study period, 122 neonates were recruited and the patients’ history was taken through using the medical records (regarding child delivery) and asking the mother. Laboratory data including total and direct bilirubin levels, serum sodium level and blood urea nitrogen (BUN) were recorded. P -value<0.05 was considered statistically significant.Results: The study was carried out on 86 exclusively breastfed neonates (EBFN) and 36 neonates with mixed type of feeding. The incidence of Hypernatremia among the EBFN and non-exclusively breastfed neonates (non-EBFN) was 9.3% and 2.7%, respectively. Moreover, 55% of the neonates with Hypernatremia had a significant weight loss (>10% cummulative weight loss). A significant correlation was observed between Hypernatremia and weight loss (P=0.008). Also, in spring and autumn, no Hypernatremia was observed among 53 cases, and during summer and winter, 9 out of 69 neonates (13%) presented with Hypernatremia (P =0.042).Conclusion: Hypernatremic dehydration is relatively common among EBFN. Regular weight monitoring, proper breastfeeding and environmental temperature control should be encouraged for preventing breastfeeding-associated Hypernatremia.

Rapid-onset obesity with hypoventilation, hypothalamic dysfunction, and autonomic dysregulation (ROHHAD) syndrome is a rare, life threatening disease with unknown etiology. Dysnatremia is a common finding in these patients. Here we present a 12-year-old boy with multiple admissions due to Hypernatremia and was repeatedly misdiagnosed. An eventual diagnosis of ROHHAD syndrome was made by integration of the previous ignored findings of sleep apnea and obesity. The diagnosis of this rare but potentially fatal syndrome should be considered in patients with dysnatremia associated with obesity and sleep apnea disorders.