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Hypotonic hyponatremia by primary polydipsia caused brain death in a 10-year-old boy

Authors
 A Ra Ko  ;  Soo Jung Kim  ;  Mo Kyung Jung  ;  Ki Eun Kim  ;  Hyun Wook Chae  ;  Duk Hee Kim  ;  Ho-Seong Kim  ;  Ah Reum Kwon 
Citation
 ANNALS OF PEDIATRIC ENDOCRINOLOGY & METABOLISM, Vol.20(3) : 166-169, 2015 
Journal Title
ANNALS OF PEDIATRIC ENDOCRINOLOGY & METABOLISM
ISSN
 2287-1012 
Issue Date
2015
Keywords
Hyponatremia ; Psychogenic polydipsia ; Water intoxication
Abstract
Hypotonic hyponatremia by primary polydipsia can cause severe neurologic complications due to cerebral edema. A 10-year-and-4-month-old boy with a psychiatric history of intellectual disability and behavioral disorders who presented with chief complaints of seizure and mental change showed severe hypotonic hyponatremia with low urine osmolality (serum sodium, 101 mmol/L; serum osmolality, 215 mOsm/kg; urine osmolality, 108 mOsm/kg). The patient had been polydipsic for a few months prior, and this had been worse in the previous few days. A diagnosis of hypotonic hyponatremia caused by primary polydipsia was made. The patient was in a coma, and developed respiratory arrest and became brain death shortly after admission, despite the treatment. The initial brain magnetic resonance imaging showed severe brain swelling with tonsillar and uncal herniation, and the patient was declared as brain death. It has been reported that antidiuretic hormone suppression is inadequate in patients with chronic polydipsia, and that this inadequate suppression of antidiuretic hormone is aggravated in patients with acute psychosis. Therefore, hyponatremia by primary polydipsia, although it is rare, can cause serious and life-threatening neurologic complications.
Files in This Item:
T201504418.pdf Download
DOI
10.6065/apem.2015.20.3.166
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아과학교실) > 1. Journal Papers
Yonsei Authors
Ko, A Ra(고아라)
Kwon, Ah Reum(권아름) ORCID logo https://orcid.org/0000-0002-9692-2135
Kim, Soo Jung(김수정)
Kim, Ho Seong(김호성) ORCID logo https://orcid.org/0000-0003-1135-099X
Jung, Mo Kyung(정모경)
Chae, Hyun Wook(채현욱) ORCID logo https://orcid.org/0000-0001-5016-8539
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/156707
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