Iatrogenic acute hyponatraemia in a college athlete.
Hyponatraemia is one of the most common electrolyte abnormalities, leading to significant morbidity and mortality. In the most basic sense, hyponatraemia can be due to sodium loss or fluid excess. The extracellular fluid status is used to clinically divide hyponatraemia into three categories to help to determine both the cause and treatment required. Hyponatraemic patients can be categorised on the basis of their fluid status as hypovolaemic, euvolaemic, or hypervolaemic. Another distinction to make in evaluating hyponatraemia is whether the onset was acute or chronic in nature. The case presented here is iatrogenic acute hypervolaemic hyponatraemia in a college athlete. The patient presented in respiratory distress with an altered mental status after the administration of hypotonic fluids for treatment of muscle cramps. Treatment included intubation, water restriction, and furosemide, to which he responded favourably. Hyponatraemia should be in the differential diagnosis for patients presenting after intravenous fluid administration.
Department of Emergency Medicine, University of Kentucky College of Medicine, Lexington 40536, USA.
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R
Herfel
C K
CK
Stone
S I
SI
Koury
J J
JJ
Blake
D000208:Acute Disease; D000328:Adult; D003221:Confusion / Q000209:etiology; D003681:Dehydration / Q000150:complications / Q000628:therapy; D003937:Diagnosis, Differential; D004232:Diuretics / Q000627:therapeutic use; D004417:Dyspnea / Q000209:etiology; D005440:Fluid Therapy / Q000009:adverse effects*; D005538:Football / Q000293:injuries; D005665:Furosemide / Q000627:therapeutic use; D005947:Glucose / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D007010:Hyponatremia / Q000209:etiology*; D007038:Hypotonic Solutions / Q000009:adverse effects / Q000627:therapeutic use; D007049:Iatrogenic Disease; D007442:Intubation, Intratracheal; D008297:Male; D009120:Muscle Cramp / Q000209:etiology / Q000628:therapy; D011654:Pulmonary Edema / Q000209:etiology; D012965:Sodium Chloride / Q000009:adverse effects / Q000627:therapeutic use; D014869:Water Intoxication / Q000209:etiology
D004232:Diuretics; D007038:Hypotonic Solutions; D012965:Sodium Chloride; D005665:Furosemide; D005947:Glucose