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A non-fatal case of sodium toxicity
Thomas C Kupiec1, John M Goldenring, Vishnu Raj
1Analytical Research Laboratories, 840 Research Parkway, Suite 546, Oklahoma City, Oklahoma 73104, USA.
Journal of Analytical Toxicology
|November 2, 2004
Summary
This case study details a six-year-old boy who survived extreme sodium toxicity (hypernatremia) after ingesting salt. His record-high serum sodium levels highlight the dangers of accidental salt poisoning.
Area of Science:
- Pediatric Toxicology
- Clinical Chemistry
- Emergency Medicine
Background:
- Hypernatremia, defined as serum sodium (Na+) > 150 mEq/L, is a critical electrolyte imbalance.
- Survival is rare with serum sodium (Na+) concentrations exceeding 160 mEq/L.
- Accidental sodium chloride ingestion can lead to severe, life-threatening hypernatremia.
Observation:
- A six-year-old boy presented with a seizure and extremely elevated serum sodium (234 mEq/L) and chloride (205 mEq/L) levels.
- Other causes of hypernatremia, including diabetes insipidus and dehydration, were ruled out.
- The child had a history of pica and ingested an estimated four tablespoons of rock salt.
Findings:
- The patient survived a non-fatal case of acute sodium toxicity with the highest documented serum sodium (Na+) level in a living person.
- Diagnosis was confirmed as acute sodium chloride poisoning due to pica and excessive salt ingestion.
- Exclusion of other causes supported the diagnosis of salt toxicity.
Implications:
- This case underscores the critical need for vigilance in preventing accidental salt ingestion in children, especially those with pica.
- It highlights the potential for survival even with unprecedentedly high serum sodium levels.
- Emphasizes prompt diagnosis and management of hypernatremia to prevent severe neurological complications.