Rhabdomyolysis associated with polydipsia induced hyponatraemia.
A 41-year-old white male with a history of alcoholism and depression was brought from prison into the emergency department (ED) after having had a witnessed tonic-clonic seizure lasting approximately 5 min. During the 24 h prior to admission, the patient's cell mate reported that he was restless and had consumed 11 litres of water. The patient had also been taking regular escitalopram for his depression. On arrival to the ED, the patient was found to have a sodium level of 112 mmol/l. After correction of his hyponatraemia the patient developed rhabdomyolisis with a creatine kinase level of 65 064 IU/l. To prevent an acute kidney injury a high volume alkaline diuresis protocol was started. Once corrected, his sodium level remained normal and he was discharged home after making a full neurological recovery. Rhabdomyolysis has rarely been associated with the correction of hyponatraemia.
Emergency Department, Adelaide and Meath incorporating the National Children's Hospital, Dublin, Ireland. mbennett1977@gmail.com
Michael
M
Bennett
Gerry
G
Fitzpatrick
Maria
M
Donnelly
D000328:Adult; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use; D015283:Citalopram / Q000627:therapeutic use; D003863:Depression / Q000188:drug therapy; D003937:Diagnosis, Differential; D006801:Humans; D007010:Hyponatremia / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D008297:Male; D059606:Polydipsia / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D012206:Rhabdomyolysis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy
D018687:Antidepressive Agents, Second-Generation; D015283:Citalopram