[Hypernatremia. Etiopathogenetic classification and description of a rare clinical case]

On the basis of a rare case of hypernatremia, the essential lines which allow a correct diagnostic and therapeutic approach to hypernatremia are underlined. Hypernatremia is classified according to the patient's state of hydratation and on the content of sodium as: hypovoloemic, euvolemic and hypervolemic. Even the concentrations of sodium in urine are often of great importance for a correct diagnosis. The patient studied suffered from hypernatremia, which is based on genetical factors. The state of dehydration, together with hypovolemia and acute tubular necrosis secondary to rhabdomyolisis, were the causes of hypernatremia. The above mentioned causes were resolved but an enterocutaneous fistula showed to be the cause, quite rare, of hypernatremia. It is suggested that this rare cause should always be mentioned when diagnosing hypernatremia; which it is important since this cause could be solved with an operation. All this was useless in our case since the patient had a drastic deterioration of his general clinical conditions.