E. Sjoblom et al., FATAL HYPONATREMIC BRAIN EDEMA DUE TO COMMON GASTROENTERITIS WITH ACCIDENTAL WATER-INTOXICATION, Intensive care medicine, 23(3), 1997, pp. 348-350
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 mo
st common aetiological factors are psychotic polydipsia and different
iatrogenic causes, this condition usually develops in hospitalised pat
ients. Water intoxication alone is very unlikely to cause severe hypon
atraemia in a person with normal renal function, unless for some reaso
n 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 hea
lthy woman. Increased awareness of this potentially fatal condition is
recommended.