Child abuse: acute water intoxication in a hyperactive child.
A 4-year-8-month-old boy was brought to our emergency department with coma and seizure. Initial physical examination showed evidence of physical child abuse and sudden body weight gain of 3.4 kg in one day. The laboratory results showed normal renal function with severe hyponatremia and the MRI study showed diffuse brain swelling. All of these findings were compatible with the diagnosis of acute water intoxication. Careful history taking from the boy and his parents separately confirmed the course of chronic polydipsia with acute compulsive water drinking. After clinical assessment and follow-up by psychiatrist, the patient was diagnosed with hyperactivity disorder. We present this case and show the possibility of correlation between compulsive water drinking, child abuse and hyperactivity disorder on acute water intoxication.
Lin
Chih-Yang
CY
Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, National Taiwan University, Taipei, Taiwan.
Tsau
Yong-Kwei
YK
D000208:Acute Disease; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications* / Q000523:psychology; D001835:Body Weight; D001921:Brain / Q000473:pathology; D002649:Child Abuse; D002675:Child, Preschool; D003128:Coma / Q000175:diagnosis / Q000209:etiology; D004632:Emergency Medical Services; D006801:Humans; D007010:Hyponatremia / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D012640:Seizures / Q000175:diagnosis / Q000209:etiology; D016896:Treatment Outcome; D014869:Water Intoxication / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy