[An 83-year-old woman with coma and severe hypernatremia].
BACKGROUND
Several cases of hypernatremia due to salt intoxication have been described. Paediatric patients and individuals with dementia or mental illness are those most commonly affected. It is a condition with a poor prognosis and a high mortality rate.


METHODS
We present an elderly, demented woman who was admitted with coma and elevated serum sodium (223 mmol/L). Recent literature on the condition has been reviewed.


CONCLUSIONS
On the basis of elevated serum sodium and urine sodium, normovolemia and normal diuresis, we concluded that hypernatremia was caused by salt intoxication. Our patient died a few hours after admittance. Recommended treatment is to maintain adequate diuresis with a loop diuretic, to and replace the ongoing fluid loss. Haemodialysis is an alternative if diuresis is inadequate. There is no consensus regarding type of replacement fluid or optimal rate of fluid replacement for hypernatremia due to salt intoxication.
Engjom
Trond
T
Medisinsk avdeling, Hålogalandssykehuset Harstad, 9480 Harstad. trond.engjom@helse-bergen.no
Kildahl-Andersen
Odd
O
D000138:Acidosis / Q000175:diagnosis / Q000209:etiology; D000368:Aged; D000369:Aged, 80 and over; D003128:Coma / Q000175:diagnosis / Q000209:etiology; D003704:Dementia / Q000150:complications; D017809:Fatal Outcome; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D006955:Hypernatremia / Q000175:diagnosis / Q000209:etiology; D012982:Sodium, Dietary / Q000506:poisoning*
D012982:Sodium, Dietary