Vanhaebost Jessica, Palmiere Cristian, Scarpelli Maria Pia, Bou Abdallah Fabiola, Capron Arnaud, Schmit Gregory
Service d'Anatomie Pathologique et Médecine Légale, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.
CURML, University Center of Legal Medicine, Chemin de la Vulliette 4, 1000, 25, Lausanne, Switzerland.
Int J Legal Med. 2018 Jan;132(1):173-179. doi: 10.1007/s00414-017-1601-y. Epub 2017 May 13.
Hyponatremia is defined as a plasma sodium concentration less than 135 or 130 mEq/L (or mmol/L) and may be responsible for life threatening symptoms that can be observed in a variety of medical conditions. Cases of fatal hyponatremia have been reported in both clinical and forensic literature in situations of water intoxication due to psychogenic polydipsia, amphetamine derivative drug intake, high-endurance exercise, iatrogenic causes, and exceptional cases of child abuse by forced water intoxication. Vitreous sodium levels have been determined to be relatively stable during the early postmortem period and similar to levels found in normal serum of living subjects. Nevertheless, there are relatively few cases of fatal hyponatremia described in literature that underwent exhaustive postmortem biochemical investigations. A case of fatal water intoxication in a psychiatric patient who underwent medicolegal investigations, including postmortem biochemistry, was chosen as a starting point to a literature review of deaths by hyponatremia that may be encountered in the forensic setting.
低钠血症的定义为血浆钠浓度低于135或130毫当量/升（或毫摩尔/升），在多种医疗状况下可能导致危及生命的症状。在临床和法医学文献中均有致命性低钠血症的病例报道，这些病例包括精神性烦渴导致的水中毒、服用苯丙胺衍生物药物、高强度耐力运动、医源性病因以及强迫水中毒虐待儿童的特殊案例。已确定玻璃体液钠水平在死后早期相对稳定，且与活体正常血清中的水平相似。然而，文献中描述的经过详尽死后生化检查的致命性低钠血症病例相对较少。选取一名接受了包括死后生化检查在内的法医学调查的精神病患者致命性水中毒案例，作为对法医学环境中可能遇到的低钠血症死亡病例进行文献综述的起点。
