An 83-year-old woman with coma and severe hypernatremia

Several cases of hypernatremia due to salt intoxication have been described. Paediatric patients and individuals with dementia or mental illness are those most commonly affected. It is a condition with a poor prognosis and a high mortality rate. We present an elderly, demented woman who was admitted...

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Bibliographic Details
Published inTidsskrift for den Norske Lægeforening Vol. 128; no. 3; p. 316
Main Authors Engjom, Trond, Kildahl-Andersen, Odd
Format Journal Article
LanguageNorwegian
Published Norway 31.01.2008
Subjects
Acidosis - diagnosis
Acidosis - etiology
Aged
Aged, 80 and over
Coma - diagnosis
Coma - etiology
Dementia - complications
Fatal Outcome
Female
Glasgow Coma Scale
Humans
Hypernatremia - diagnosis
Hypernatremia - etiology
Sodium, Dietary - poisoning
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Summary:Several cases of hypernatremia due to salt intoxication have been described. Paediatric patients and individuals with dementia or mental illness are those most commonly affected. It is a condition with a poor prognosis and a high mortality rate. We present an elderly, demented woman who was admitted with coma and elevated serum sodium (223 mmol/L). Recent literature on the condition has been reviewed. On the basis of elevated serum sodium and urine sodium, normovolemia and normal diuresis, we concluded that hypernatremia was caused by salt intoxication. Our patient died a few hours after admittance. Recommended treatment is to maintain adequate diuresis with a loop diuretic, to and replace the ongoing fluid loss. Haemodialysis is an alternative if diuresis is inadequate. There is no consensus regarding type of replacement fluid or optimal rate of fluid replacement for hypernatremia due to salt intoxication.
ISSN:0807-7096