Fatal hyponatraemic brain oedema due to common gastroenteritis with accidental water intoxication

Acute symptomatic hyponatraemia is a life-threatening emergency which must be diagnosed and treated promptly. The initial symptoms are often dramatic, with seizures and coma, and there is therefore a risk that the diagnosis and the urgent sodium correction therapy may be delayed by procedures such a...

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Bibliographic Details
Published in:Intensive care medicine 1997-03, Vol.23 (3), p.348-350
Main Authors: SJÖBLOM, E, HÖJER, J, LUDWIGS, U, PIRSKANEN, R
Format: Article
Language:English
Subjects:
Acute Disease
Adult
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Antidiuretics
Autopsies
Biological and medical sciences
Brain
Brain Edema - etiology
Case reports
Coma
Computed tomography
Convulsions & seizures
Dehydration
Edema
Electrolytes
Emergency and intensive care: metabolism and nutrition disorders. Enteral and parenteral nutrition
Emergency medical care
Fatal Outcome
Female
Gastroenteritis
Gastroenteritis - complications
Hemorrhage
Hormones
Hospitals
Humans
Hyponatremia
Hyponatremia - diagnosis
Hyponatremia - etiology
Iatrogenesis
Intensive care
Intensive care medicine
Intoxication
Medical imaging
Medical sciences
Medicin och hälsovetenskap
Mortality
Patients
Polydipsia
Potassium
Psychosis
Renal function
Secretion
Seizures
Sodium
Sodium - administration & dosage
Tomography
Tomography, X-Ray Computed
Ventilators
Water Intoxication - complications
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Description
Summary:Acute symptomatic hyponatraemia is a life-threatening emergency which must be diagnosed and treated promptly. The initial symptoms are often dramatic, with seizures and coma, and there is therefore a risk that the diagnosis and the urgent sodium correction therapy may be delayed by procedures such as computed tomography (CT) of the brain. As the most common aetiological factors are psychotic polydipsia and different iatrogenic causes, this condition usually develops in hospitalised patients. Water intoxication alone is very unlikely to cause severe hyponatraemia in a person with normal renal function, unless for some reason the antidiuretic hormone secretion is increased. We describe a case in which dehydration due to common gastroenteritis in combination with excessive intake of water caused the death of a young, previously healthy woman. Increased awareness of this potentially fatal condition is recommended.
ISSN:0342-4642
1432-1238
DOI:10.1007/s001340050340