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

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.