Severe hyponatremia in spinal cord injury.
A male quadriplegic (C6--complete) with persistent chronic hyponatremia (serum sodium values ranging consistently from 117-132 mmol/L) developed acute hyponatremia with a serum sodium concentration of 98 mmol/L. This extreme hyponatremia related, in part, to a reversible defect in the excretion of a water load, while on a low (46 mmol/day) sodium diet. Subsequent ingestion of a normal sodium diet (150 mmol/day), with or without 0.1 mg of fludrocortisone (Florinef), reestablished his ability to excrete a water load normally. The etiology of this patient's hyponatremia is discussed as well as the unique concordance of factors which make hyponatremia a common occurrence among spinal-cord injured patients.
Sica
D A
DA
Division of Nephrology, Medical College of Virginia, Richmond.
Culpepper
R M
RM
D000208:Acute Disease; D004039:Diet, Sodium-Restricted; D005438:Fludrocortisone / Q000627:therapeutic use; D006801:Humans; D007010:Hyponatremia / Q000097:blood / Q000178:diet therapy / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009994:Osmolar Concentration; D012982:Sodium, Dietary / Q000008:administration & dosage; D013119:Spinal Cord Injuries / Q000097:blood / Q000150:complications*; D014667:Vasopressins / Q000097:blood; D014869:Water Intoxication / Q000209:etiology; D014882:Water-Electrolyte Balance
D012982:Sodium, Dietary; D014667:Vasopressins; D005438:Fludrocortisone