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首页> 外文期刊>Case Reports in Nephrology and Dialysis >A Case of Water Intoxication with Prolonged Hyponatremia Caused by Excessive Water Drinking and Secondary SIADH
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A Case of Water Intoxication with Prolonged Hyponatremia Caused by Excessive Water Drinking and Secondary SIADH

机译：饮水过量和继发性SIADH引起的中毒时间过长的低钠血症

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Water intoxication is a life-threatening disorder accompanied by brain function impairment due to severe dilutional hyponatremia. We treated a 22-year-old man without psychotic illness who had been put in a detention facility. He drank 6 liters of water over a 3-hour period at the facility as a game's penalty, and he showed progressive psychiatric and neurological signs including restlessness, peculiar behavior and convulsions. On his admission, 15 h after the discontinuation of the water drinking, he was in a coma, showing intermittent convulsions and remarkable hyponatremia (120 mmol/l). Because his laboratory tests showed hypertonic urine and normal sodium excretion, the diagnosis of secondary development of syndrome of inappropriate secretion of antidiuretic hormone (SIADH) was strongly suggested and later confirmed by the suppression of the renin-aldosterone system and the inappropriately elevated secretion of ADH. Saline infusion and an initial administration of furosemide in addition to dexamethasone as treatments for the patient's brain edema successfully improved his laboratory data and clinical signs by the 3rd hospital day, and he was returned to the facility without physical or psychiatric abnormalities on the 6th day. The secondary SIADH might have been due to the prolonged emesis, recurrent convulsions and rapid elevation of intracranial pressure.
机译：水中毒是一种严重的稀释性低钠血症，可危及生命，并伴有脑功能损害。我们治疗了一个被关押在监狱中的没有精神病的22岁男子。作为比赛的惩罚，他在该场所喝了6升水，历时3个小时，并且他表现出进行性精神病和神经症状，包括躁动不安，行为异常和抽搐。入院后，中止饮水15小时，他处于昏迷状态，表现为间歇性抽搐和显着的低钠血症（120 mmol / l）。由于他的实验室检查显示尿液高渗和钠排泄正常，因此强烈建议诊断为抗利尿激素分泌异常综合征（SIADH）的继发性发展，后来通过抑制肾素-醛固酮系统和ADH分泌不适当而得到证实。盐水输注和除地塞米松外首次应用速尿治疗患者脑水肿的方法已成功改善了他的实验室数据和临床体征，并在第3天住院了，而他在第6天被送回该医院，没有身体或精神异常。继发性SIADH可能是由于长时间的呕吐，反复发作的抽搐和颅内压迅速升高所致。

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