Goldszer R C, Coodley E L
Arch Intern Med. 1979 Aug;139(8):936-7.
In a 74-year-old woman, excessive insensible water loss developed secondary to a period of hot, humid weather, associated with an underlying inability to obtain adequate water replacement. On admission to the hospital she was comatose, clinically dehydrated, and had laboratory values consistent with a water deficit of approximately 30% (9 L) of body water. Serum sodium concentration was 202 mEq/L. Serum osmolality was 430 mOsm/L. The patient remained comatose for seven days, during which time she was vigorously treated with fluids, and she gradually recovered. This case represents what we believe is a unique report in the literature of the severity of hypernatremia developing via this pathogenic mechanism and survival in an adult with this degree of disturbance of sodium and water homeostasis.
一名74岁女性，在一段炎热潮湿的天气中，因潜在的无法获得足够水分补充，出现了过多的不显性失水。入院时她昏迷，临床脱水，实验室检查结果显示机体水分缺失约占总体液的30%（9升）。血清钠浓度为202 mEq/L。血清渗透压为430 mOsm/L。患者昏迷了七天，在此期间积极进行补液治疗，随后逐渐康复。我们认为该病例是文献中通过这种致病机制发生的高钠血症严重程度以及成人在这种程度的钠和水平衡紊乱下存活的独特报道。
