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Rhabdomyolysis with severe hypernatremia
The Journal of Pediatrics
|May 1, 1977
Insights
Severe hypernatremia in children can cause profound weakness, rhabdomyolysis, and myoglobinuria. These rare complications, including respiratory and cardiac issues, highlight the critical impact of electrolyte imbalances.
Area of Science:
- Pediatric Nephrology
- Pediatric Critical Care
- Biochemistry
Background:
- Severe hypernatremia is a critical electrolyte disturbance in children.
- It can lead to significant neurological and systemic complications.
Observation:
- Three children with severe hypernatremia presented with profound generalized weakness.
- Biochemical evidence indicated rhabdomyolysis and myoglobinuria in all affected children.
Findings:
- The combination of severe hypernatremia, rhabdomyolysis, and myoglobinuria is previously unreported in pediatric cases.
- Complications included respiratory failure in one child and cardiac arrhythmias in two.
- All three children developed acute renal insufficiency, with one requiring peritoneal dialysis.
Implications:
- This case series underscores the potential for severe neuromuscular and renal complications in pediatric hypernatremia.
- Early recognition and management of hypernatremia are crucial to prevent life-threatening consequences.
- Further research into the pathophysiology linking hypernatremia to rhabdomyolysis is warranted.
Abstract:
Three children with severe hypernatremia presented with profound generalized weakness and biochemical evidence of rhabdomyolysis and myoglobinuria. These findings in combination have not been previously reported, to our knowledge, in children with severe hypernatremia. Unusual complications included respiratory failure in one child and cardiac arrhythmias in two children. All three children had acute renal insufficiency; one required peritoneal dialysis.