https://doi.org/10.4081/ecj.2022.10364

Severe hyponatremia due to water intoxication in a child with sickle cell disease: A case report

Vol. 18 No. 2 (2022)
Submitted: 14 January 2022
Accepted: 12 April 2022
Published: 27 June 2022
Sickling, antidiuretic hormone, rhabdomyolysis, seizures
Abstract Views: 915
PDF: 215
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Authors

Roberta Rossi
Department of Pediatric Emergency, Regina Margherita Children’s Hospital - A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy.
Emanuele Castagno
ecastagno@cittadellasalute.to.it
http://orcid.org/0000-0001-7756-5075
Department of Pediatric Emergency, Regina Margherita Children’s Hospital - A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy.
Patrizia Matarazzo
Pediatric Endocrinology Unit, Regina Margherita Children’s Hospital - A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy.
Gerdi Tuli
Pediatric Endocrinology Unit, Regina Margherita Children’s Hospital - A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy.
Paola Saracco
Pediatric Hematology Unit, Regina Margherita Children’s Hospital - A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy.
Antonio F. Urbino
Department of Pediatric Emergency, Regina Margherita Children’s Hospital - A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy.
Claudia Bondone
Department of Pediatric Emergency, Regina Margherita Children’s Hospital - A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy.

Water intoxication is a potentially fatal hypo-osmolar syndrome with brain function impairment. Isolated symptomatic excessive ingestion of free water is very rare in childhood. We report a case of acute hyponatremia due to water intoxication without Antidiuretic Hormone (ADH) excess in a child with sickle cell disease. The boy was admitted to our Emergency Department because of new-onset prolonged generalized seizures. Blood test showed hyponatremia, and elevated creatine kinase value; neuroimaging was negative. His recent medical history revealed that on the day before he had drunk about 4 liters of water in 2 hours to prevent sickling, because of back pain. He was treated with mild i.v. hydration with normal saline solution and showed progressive clinical improvement and normalization of laboratory test. Rhabdomyolysis is a rare complication of hyponatremia whose underlying mechanism is still unclear.

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How to Cite

Rossi, R., Castagno, E., Matarazzo, P., Tuli, G., Saracco, P., Urbino, A. F., & Bondone, C. (2022). Severe hyponatremia due to water intoxication in a child with sickle cell disease: A case report. Emergency Care Journal, 18(2). https://doi.org/10.4081/ecj.2022.10364

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