Korzets A, Ori Y, Floro S, Ish-Tov E, Chagnac A, Weinstein T, Zevin D, Gruzman C
Department of Nephrology, Hasharon Hospital, Golda Medical Center, Petah-Tikva, Israel.
Am J Med Sci. 1996 Aug;312(2):92-4. doi: 10.1097/00000441-199608000-00007.
A 28-year-old woman, treated for schizophrenia, developed severe hypotonic hyponatremia (serum Na: 109 mEq/L) after several days of compulsive water drinking. The patient was admitted in a coma and required intensive supportive therapy. Rhabdomyolysis quickly followed with high serum creatine phosphokinase levels and myoglobinuria. A high volume alkaline diuresis was initiated. Renal failure or compartment syndrome did not complicate the clinical picture. The mechanisms causing water intoxication and hyponatremia are discussed as are the possible pathogenetic explanations behind acute hyponatremia and rhabdomyolysis.
一名28岁的精神分裂症女性患者，在强迫性饮水数天后出现严重的低渗性低钠血症（血清钠：109 mEq/L）。患者入院时处于昏迷状态，需要重症支持治疗。随后很快出现横纹肌溶解，血清肌酸磷酸激酶水平升高并伴有肌红蛋白尿。开始进行大量碱性利尿治疗。肾衰竭或骨筋膜室综合征并未使临床情况复杂化。文中讨论了导致水中毒和低钠血症的机制，以及急性低钠血症和横纹肌溶解背后可能的发病原因解释。
