Evanson Davin J, Espiridion Eduardo D
Division of Diagnostic Radiology, Drexel University College of Medicine, Wyomissing, USA.
Psychiatry, West Virginia School of Osteopathic Medicine, Lewisburg, USA.
Cureus. 2023 Sep 6;15(9):e44766. doi: 10.7759/cureus.44766. eCollection 2023 Sep.
Patients with hyponatremia are at risk of severe complications including seizures, coma, and death. Psychiatric patients are particularly susceptible to death from hyponatremia due to the association between psychiatric conditions and psychogenic polydipsia, characterized by water intoxication. We report a case of a schizophrenic patient who presented with altered mental status, leading to a differential diagnosis narrowed through clinical investigations to include hypovolemic hyponatremia, syndrome of inappropriate antidiuretic hormone secretion (SIADH), and psychogenic polydipsia. This case underscores the need to inquire about schizophrenic patients' water intake, advocating for a standardized approach. The timely diagnosis of disorders causing electrolyte abnormalities can prevent severe complications and aid in the management of psychiatric patients.
低钠血症患者有发生严重并发症的风险,包括癫痫发作、昏迷和死亡。精神科患者由于精神疾病与精神性烦渴(其特征为水中毒)之间的关联,特别容易因低钠血症而死亡。我们报告了一例精神状态改变的精神分裂症患者,通过临床检查将鉴别诊断范围缩小至包括低血容量性低钠血症、抗利尿激素分泌不当综合征(SIADH)和精神性烦渴。该病例强调了询问精神分裂症患者水摄入量的必要性,提倡采用标准化方法。及时诊断导致电解质异常的疾病可预防严重并发症,并有助于精神科患者的管理。