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Rhabdomyolysis associated with polydipsia induced hyponatraemia
Michael Bennett1, Gerry Fitzpatrick, Maria Donnelly
1Emergency Department, Adelaide and Meath incorporating the National Children's Hospital, Dublin, Ireland. mbennett1977@gmail.com
BMJ Case Reports
|June 9, 2012
Summary
Severe hyponatremia, often linked to excessive water intake, can cause seizures. Rapid correction of this electrolyte imbalance can paradoxically lead to rhabdomyolysis, a serious muscle condition.
Area of Science:
- Nephrology
- Neurology
- Endocrinology
Background:
- A 41-year-old male with a history of alcoholism and depression presented with a tonic-clonic seizure.
- The patient reported excessive water consumption (11 liters) in the 24 hours preceding admission.
- He was also on escitalopram for depression.
Observation:
- On admission, the patient exhibited severe hyponatremia with a serum sodium level of 112 mmol/l.
- Following correction of hyponatremia, the patient developed rhabdomyolysis, indicated by a creatine kinase level of 65,064 IU/l.
Findings:
- The case highlights a rare association between the correction of hyponatremia and the subsequent development of rhabdomyolysis.
- A high-volume alkaline diuresis protocol was initiated to prevent acute kidney injury.
Implications:
- This case underscores the importance of careful electrolyte management in patients with severe hyponatremia.
- Clinicians should be vigilant for potential complications like rhabdomyolysis during hyponatremia correction.
- Further research may be warranted to elucidate the mechanisms linking hyponatremia correction to rhabdomyolysis.
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