title: Symptomatic hypotonic hyponatremia presenting at high altitude.
abstract: We present a case of altered mental status and seizure that occurred at an altitude known to cause high altitude-related illnesses. Based on the presenting symptoms, the patient was initially transferred to the hospital with a presumptive diagnosis of high altitude cerebral edema. On review of imaging and laboratory data, she was found to be experiencing symptomatic hypotonic hyponatremia. This case presented an interesting diagnostic challenge and underscores the importance of maintaining a broad differential diagnosis when evaluating a patient with altered mental status from an alpine setting.
authors.affiliation: Department of Emergency Medicine, UCSF Fresno Medical Education Program, Fresno, CA (Dr Spano). Electronic address: sspano@gmail.com.
authors.forename: Susanne J
authors.initials: SJ
authors.lastname: Spano
authors.affiliation: Department of Internal Medicine, UCSF Fresno Medical Education Program, Fresno CA (Drs Reagle and Evans).
authors.forename: Zacharia
authors.initials: Z
authors.lastname: Reagle
authors.affiliation: Department of Internal Medicine, UCSF Fresno Medical Education Program, Fresno CA (Drs Reagle and Evans).
authors.forename: Timothy
authors.initials: T
authors.lastname: Evans
mesh_terms: D000328:Adult; D000531:Altitude; D001929:Brain Edema / Q000175:diagnosis / Q000209:etiology; D002140:California; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007010:Hyponatremia / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology*; D012462:Saline Solution, Hypertonic / Q000627:therapeutic use; D012964:Sodium / Q000097:blood
chemical_list: D012462:Saline Solution, Hypertonic; D012964:Sodium
keywords: exertional associated hyponatremia (EAH); high altitude cerebral edema; hypertonic saline (HTS); hyponatremia; search and rescue; syndrome of inappropriate antidiuretic hormone (SIADH)