Two unusual pediatric cases of dilutional hyponatremia.

Abstract:

:Dilutional hyponatremia, although not uncommon, is an underestimated problem in the pediatric population. In most cases, it results from excessive hydration or water retention, also described as the so-called water intoxication. One of the most known causes is the use of desmopressin in enuretic children. This drug enhances the free water reabsorption in the renal collecting ducts. The addition of the anticholinergic agent oxybutynin aggravated the condition by causing a dry mouth with excessive thirst and water intake in our first case. Dietary water overconsumption, either voluntary or involuntary, is a phenomenon seen in formula-fed babies. But in our second case, a game involving forced ingestion of large amounts of water had serious consequences including hyponatremia-related coma. An effort should therefore be made to inform caretakers about the risks of these games. These cases, provoked by rather unusual and peculiar causes, illustrate again that electrolytes and especially serum [Na(+)] are key points to be determined in a child with diminished consciousness. Moreover, an accurate history including the intake of medication and dietary information should be made.

journal_name

Pediatr Emerg Care

journal_title

Pediatric emergency care

authors

Boetzkes S,Van Hoeck K,Verbrugghe W,Ramet J,Wojciechowski M,Jorens PG

doi

10.1097/PEC.0b013e3181e5bf9e

subject

Has Abstract

pub_date

2010-07-01 00:00:00

pages

503-5

issue

7

eissn

0749-5161

issn

1535-1815

pii

00006565-201007000-00009

journal_volume

26

pub_type

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