Symptomatic Hypotonic Hyponatremia Presenting at High Altitude

• Published in: Wilderness & environmental medicine Vol. 25; no. 1; pp. 69 - 74
• Main Authors: Spano, Susanne J., Reagle, Zacharia, Evans, Timothy
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA Elsevier Inc 01.03.2014; SAGE Publications
• Subjects: Adult; Altitude; Brain Edema - diagnosis; Brain Edema - etiology; California; Diagnosis, Differential; Emergency; exertional associated hyponatremia (EAH); Female; high altitude cerebral edema; Humans; hypertonic saline (HTS); hyponatremia; Hyponatremia - diagnosis; Hyponatremia - drug therapy; Hyponatremia - etiology; Saline Solution, Hypertonic - therapeutic use; search and rescue; Sodium - blood; syndrome of inappropriate antidiuretic hormone (SIADH); California; search and rescue; syndrome of inappropriate antidiuretic hormone (SIADH); high altitude cerebral edema; hyponatremia; hypertonic saline (HTS); exertional associated hyponatremia (EAH)
• ISSN: 1080-6032; 1545-1534
• DOI: 10.1016/j.wem.2013.09.014

We present a case of altered mental status and seizure that occurred at an altitude known to cause high altitude-related illnesses. Based on the presenting symptoms, the patient was initially transferred to the hospital with a presumptive diagnosis of high altitude cerebral edema. On review of imaging and laboratory data, she was found to be experiencing symptomatic hypotonic hyponatremia. This case presented an interesting diagnostic challenge and underscores the importance of maintaining a broad differential diagnosis when evaluating a patient with altered mental status from an alpine setting.