Hyponatremia-associated rhabdomyolysis.
BACKGROUND
Hyponatremia is the most frequent electrolyte disorder. However, hyponatremia rarely results from excessive water intake, unless the kidney is unable to excrete free water, such as in patients on thiazide diuretics; in addition, hyponatremia is an uncommon cause of rhabdomyolysis.


METHODS
We present a 51-year-old hypertensive woman on chronic hydrochlorothiazide therapy who developed acute water intoxication and severe myalgias.


RESULTS
The patient developed acute hypotonic hyponatremia and subsequent rhabdomyolysis. We discuss the mechanisms responsible for the development of hyponatremia and its association with rhabdomyolysis.


CONCLUSIONS
Muscle enzymes should be monitored in patients with acute hyponatremia who develop muscle pain, and hyponatremia-induced rhabdomyolysis must be considered in patients with myalgias receiving thiazide diuretics.
Servicio de Nefrología y Hemodiálisis, Hospital Británico de Buenos Aires, Argentina.
H
H
Trimarchi
J
J
Gonzalez
J
J
Olivero
D001581:Benzothiadiazines; D001794:Blood Pressure; D001834:Body Water; D004232:Diuretics; D004326:Drinking; D005260:Female; D006801:Humans; D007010:Hyponatremia / Q000150:complications* / Q000188:drug therapy; D008875:Middle Aged; D012206:Rhabdomyolysis / Q000209:etiology*; D049993:Sodium Chloride Symporter Inhibitors / Q000009:adverse effects / Q000627:therapeutic use
D001581:Benzothiadiazines; D004232:Diuretics; D049993:Sodium Chloride Symporter Inhibitors