Ozbiljna hiponatrijemija i intoksikacija vodom - Dijagnostički izazov u hitnoj medicini
| Autor: | Ana Pupić-Bakrač, Jeremije Radović, Dušan Pupić-Bakrač, Jure Pupić-Bakrač, Dino Markota |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Health (social science) business.industry polidipsija psihogen hiponatrijemija intoksikacija vodom Medicine (miscellaneous) medicine.disease 03 medical and health sciences Psychiatry and Mental health Clinical Psychology 0302 clinical medicine polydipsia psychogenic hyponatremia water intoxication Emergency medicine medicine Psychogenic disease Water intoxication 030212 general & internal medicine medicine.symptom Hyponatremia business Polydipsia 030217 neurology & neurosurgery |
| Zdroj: | Alcoholism and psychiatry research : Journal on psychiatric research and addictions Volume 53 Issue 2 |
| ISSN: | 1849-8582 1849-1251 |
| Popis: | Psychogenic polydipsia is a disorder characterized by compulsive drinking of water in a population of psychiatric patients, most often those suffering from chronic psychosis. It can lead to severe dilutional hyponatremia and water intoxication, which is manifested by cerebral edema and associated neurological symptomatology. A 43 years-old patient was admitted to the Department of Emergency Medicine due to convulsions of the right hand and leg, which began one hour before arrival. During the episode, the patient was conscious, vomited once and had urinary incontinence. In the medical history he had epilepsy, chronic psychosis and moderate mental retardation. Vital parameters were stable, and physical examination did not reveal any associated pathological signs. Samples for laboratory analysis were taken and therapy with infusions of Diazepam (20 mg) included, to which patient was resistant. By heteroanamnesis it was acknowledged that in the last few days he spent more time than usual drinking water. Reviewing laboratory results it was found out that sodium concentration was 98 mmol/L. We began the gradual correction of sodium, after which the patient reached the full extent of recovery. Water intoxication is an emergency condition that is in clinical practice often mistaken for other neurological and internal emergency states, because of its non-specific symptomatology. With timely diagnosis and application of adequate treatment, recovery is complete. Psihogena polidipsija je poremećaj kompulzivnog pijenja vode u psihijatrijskih pacijenata, najčešće onih koji boluju od kronične psihoze. Poremećaj može uzrokovati tešku hiponatrijemiju i intoksikaciju vodom, a manifestira se putem cerebralnog edema i popratnih neuroloških simptoma. 43-godišnji pacijent zaprimljen je na odjel hitne medicine zbog konvulzija desne ruke i noge koje su započele jedan sat prije dolaska. Za vrijeme trajanja napada pacijent je bio pri svijesti, jednom je povraćao i imao urinarnu inkontinenciju. Anamneza je pokazala da pacijent boluje od epilepsije, kronične psihoze i umjerene mentalne retardacije. Vitalni parametri su bili stabilni i tijekom fizičkog pregleda nisu uočeni nikakvi popratni patološki znakovi. Uzeti su uzorci za laboratorijsku analizu i i putem infuzije je uključena terapija diazepama (20mg) na koju je pacijent bio rezistentan. Iz heteroanamnestičkih podataka utvrđeno je da je pacijent posljednjih nekoliko dana proveo dosta vremena pijući vodu. Laboratorijski nalazi su pokazali da je koncentracija natrija 98 mmol/l. Postepeno smo počeli normalizirati razinu natrija nakon čega se pacijent u potpunosti oporavio. Intoksikacija vodom je hitno stanje koje se u kliničkoj praksi često zamijeni s drugim neurološkim i internističkim hitnim stanjima zbog svoje nespecifične simptomatologije. Pravovremenom dijagnozom i odgovarajućom terapijom oporavak je potpun. |
| Databáze: | OpenAIRE |
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