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M. W. El-Nachef, MD; M. S. Darwich, MD
Northwest Mississippi Regional Medical Center Clarksdale

JAMA. 1990;264(23):2993-2994.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

A malnourished 67-year-old patient presented to the emergency department with hypothermia and obtundation after drinking ice-cold Diet Coke.

Report of a Case.—

A 67-year-old white woman with over 20 years' history of diabetes mellitus type I started maintenance hemodialysis 2 years ago when her diabetic nephropathy progressed to end-stage renal disease. She also developed severe autonomic neuropathy with recurrent vomiting and resultant malnutrition, muscle wasting, and weight loss of over 20 kg in less than 2 years.

In the night before her admission, the patient became very upset on hearing some news about her family. She felt as though her throat was set on fire, and she drank ice-cold Diet Coke all night long, consuming about 20 cans or 7 L containing 0.7 g of sodium. In the early hours of the morning, the family noticed that the patient's speech had become unclear. When she arrived at . . . [Full Text PDF of this Article]

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