A. Korzets et al., SEVERE HYPONATREMIA AFTER WATER-INTOXICATION - A POTENTIAL CAUSE OF RHABDOMYOLYSIS, The American journal of the medical sciences, 312(2), 1996, pp. 92-94
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.