Bennett Michael, Fitzpatrick Gerry, Donnelly Maria
Emergency Department, Adelaide and Meath incorporating the National Children's Hospital, Dublin, Ireland.
BMJ Case Rep. 2011 Oct 4;2011:bcr0820114659. doi: 10.1136/bcr.08.2011.4659.
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.
一名41岁有酗酒和抑郁症病史的白人男性,在目睹其发生持续约5分钟的强直阵挛性癫痫发作后,从监狱被送至急诊科(ED)。入院前24小时内,患者的狱友称他烦躁不安,饮用了11升水。该患者还一直在规律服用艾司西酞普兰治疗抑郁症。到达急诊科时,发现患者血钠水平为112 mmol/L。纠正其低钠血症后,患者发生横纹肌溶解,肌酸激酶水平达65064 IU/L。为预防急性肾损伤,启动了高容量碱性利尿方案。血钠水平纠正后保持正常,患者神经系统完全恢复后出院。横纹肌溶解很少与低钠血症的纠正相关。