Unusual Presentation of Hyponatremia: Persistent Hiccups.

Hyponatremia is a common electrolyte disturbance with well-recognized neurological and gastrointestinal symptoms. However, it rarely presents with atypical manifestations, such as persistent hiccups. We report a case of a 36-year-old woman with necrotizing tonsillitis who developed persistent hiccups 3 days prior to hospitalization. Laboratory evaluation revealed severe hyponatremia (serum sodium [Na] 122.4 mEq/L), consistent with the syndrome of inappropriate antidiuretic hormone secretion (SIADH). Despite symptomatic treatment, hiccups persisted until serum Na levels were gradually corrected with hypertonic saline and fluid restriction. Hiccups resolved with improved Na levels. This case underscores the importance of considering hyponatremia in the differential diagnosis of persistent hiccups and highlights SIADH as a potential underlying cause.