SEVERE HYPONATREMIA AFTER WATER-INTOXICATION - A POTENTIAL CAUSE OF RHABDOMYOLYSIS

A 28-year-old woman, treated for schizophrenia, developed severe hypot onic hyponatremia (serum Na: 109 mEq/L) after several days of compulsi ve water drinking. The patient was admitted in a coma and required int ensive supportive therapy. Rhabdomyolysis quickly followed with high s erum creatine phosphokinase levels and myoglobinuria. A high volume al kaline diuresis was initiated, Renal failure or compartment syndrome d id not complicate the clinical picture. The mechanisms causing water i ntoxication and hyponatremia are discussed as are the possible pathoge netic explanations behind acute hyponatremia and rhabdomyolysis.