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PubMedDate not supplied

Child abuse: acute water intoxication in a hyperactive child.

A 4-year-8-month-old boy was brought to our emergency department with coma and seizure. Initial physical examination showed evidence of physical child abuse and sudden body weight gain of 3.4 kg in one day. The laboratory results showed normal renal function with severe hyponatremia and the MRI study showed diffuse brain swelling. All of these findings were compatible with the diagnosis of acute water intoxication. Careful history taking from the boy and his parents separately confirmed the course of chronic polydipsia with acute compulsive water drinking. After clinical assessment and follow-up by psychiatrist, the patient was diagnosed with hyperactivity disorder. We present this case and show the possibility of correlation between compulsive water drinking, child abuse and hyperactivity disorder on acute water intoxication.

Acute Disease↗
PubMed1991

The successful treatment of psychogenic polydipsia and water intoxication with propanolol. A case report.

Psychogenic polydipsia (PPD), which can lead to water intoxication (WI), is a problem with many psychiatric patients. The case history of one schizophrenic patient presented here shows that propanolol therapy can reduce PPD and WI, possibly decrease thirst, and improve schizophrenic symptoms and behavior. When combined with regular weight evaluation and behavioral treatment to restrict water intake, the therapy can further reduce the risk of developing life-threatening WI complications.

Adult↗
PubMed1987

[Acute water intoxication after prolonged infusion of oxytocin].

The authors report a case of acute water intoxication with severe neurological features which complicated prolonged administration of oxytocin for post-partum hemorrhage. The patient was a 35-year-old woman with a tight mitral stenosis. The patient recovered consciousness after the hydro-electrolytic state had been put right. The precautions that have to be undertaken and the monitoring that is necessary to avoid hyponatraemia with water retention are reviewed. It is important to know the risk factors which are connected with this treatment and how certain abnormal conditions of the heart can play a role in causing this syndrome.

Adult↗
PubMed1985

[Water intoxication in children. Apropos of 2 cases].

The authors report 2 cases of water intoxication. These clinical cases show the importance of neurological signs during the acute period. Hyponatremia is constant and responsible for the clinical signs. A rapid treatment is necessary.

Adolescent↗
PubMed1998

Water intoxication in anorexia nervosa: a case report.

OBJECTIVE AND METHOD: A case of water intoxication in a patient with anorexia nervosa is reported. RESULTS: Differently from the other cases previously reported, the patient had a long duration of illness (13 years). A compulsory treatment was necessary since the patient refused any cooperation and her weight had dropped to 19.5 kg (body mass index = 8.3). After a slow weight recovery and a multidisciplinary inpatient treatment of 15 months, the patient started an outpatient treatment. One month later she complained of headache, vomiting, and grand-mal seizures with hyponatremia, hypokalemia, hypochloremia, and low urine osmolarity. Later, we were able to learn from her that some weeks before she had begun to drink large amounts of water before the weight control visits to maintain the target weight. After this episode, she carried on the abnormal drinking habit, although she knew the risks related to excessive drinking. DISCUSSION: Studies on larger samples are needed to understand the risk factors for abnormal drinking habits in anorexia nervosa.

Adult↗
PubMed2000

Aquaporin-4 deletion in mice reduces brain edema after acute water intoxication and ischemic stroke.

Cerebral edema contributes significantly to morbidity and death associated with many common neurological disorders. However, current treatment options are limited to hyperosmolar agents and surgical decompression, therapies introduced more than 70 years ago. Here we show that mice deficient in aquaporin-4 (AQP4), a glial membrane water channel, have much better survival than wild-type mice in a model of brain edema caused by acute water intoxication. Brain tissue water content and swelling of pericapillary astrocytic foot processes in AQP4-deficient mice were significantly reduced. In another model of brain edema, focal ischemic stroke produced by middle cerebral artery occlusion, AQP4-deficient mice had improved neurological outcome. Cerebral edema, as measured by percentage of hemispheric enlargement at 24 h, was decreased by 35% in AQP4-deficient mice. These results implicate a key role for AQP4 in modulating brain water transport, and suggest that AQP4 inhibition may provide a new therapeutic option for reducing brain edema in a wide variety of cerebral disorders.

Animals↗
PubMed2002

Fatal water intoxication of an Army trainee during urine drug testing.

An Army trainee developed acute water intoxication, hyponatremia, pulmonary edema, and fatal cerebral edema. This is the first report of a fatality related to urine drug testing. This resulted from supervised excessive water ingestion in an attempt to induce a sufficient urine specimen for substance abuse testing. To avoid a similar preventable death in the future, we make several recommendations. These include limiting the volume of ingested fluid to eight ounces every 30 to 45 minutes, not to exceed 40 ounces, and providing a relaxed, reassuring environment when obtaining urine specimens for substance abuse detection.

Adult↗
PubMed1997

[Rhabdomyolysis following water intoxication in two schizophrenic patients].

We report two cases of self-induced water intoxication with rhabdomyolysis. They had been diagnosed as chronic schizophrenia, and admitted to mental hospitals. The patients were transferred to our emergency room because of sudden loss of consciousness and generalized convulsions. Laboratory findings revealed marked hyponatremia (case 1; 109 mEq/L and case 2; 104 mEq/L). CT scans showed the effacement of interhemispheric and bilateral sylvian fissures and sulci of the cerebral hemisphere due to diffuse brain edema. 10% glycerol and saline were intravenously injected to the patients. They recovered from hyponatremia after excreting a large amount of urine. Their disturbed consciousness recovered to the normal level in parallel with the normalization of their serum sodium concentration. Soon after the normalization of their consciousness level, their serum creatine kinase (CK) was markedly elevated (case 1; 13086 IU/L and case 2; 41832 IU/L), and their serum myoglobin level was also significantly elevated (case 1; 2670 ng/ml and case 2; 1420 ng/ml). A sufficient amount of transfusion was performed for avoiding the acute renal failure. The two patients recovered from rhabdomyolysis without any severe complication. We conclude that brain CT is useful for the diagnosis of brain edema, and monitoring of CK is also important to anticipate renal damage secondary to rhabdomyolysis.

Adult↗
PubMed1977

Water intoxication and oxytocin infusion.

The case reports are presented of two patients who developed water intoxication after high-dose oxytocin infusions. Plasma sodium and urine flow were studied in two further patients given high-dose oxytocin infusions. The findings are related to previously published observations.

Adult↗
PubMed1988

Self-induced water intoxication. A case report.

A 19-year-old female schizophrenic with self-induced water intoxication is described. Factors of pathogenic significance included primary polydipsia and non-maximal urinary diluting capacity.

Adult↗
PubMed1991

Water intoxication: a complication of pelvic US in a patient with syndrome of inappropriate antidiuretic hormone secretion.

A woman was first seen with water intoxication caused by the voluntary ingestion of water in an attempt to fill her bladder before undergoing pelvic ultrasound (US). As in two other reported cases, this woman was receiving medication that causes the syndrome of inappropriate antidiuretic hormone secretion. A patient undergoing transabdominal pelvic US who is receiving these medications and whose bladder is not full should undergo examination by means of a transvaginal or endorectal route.

Aged↗
PubMed1991

Oral water intoxication in infants. An American epidemic.

Between 1975 and 1990, a total of 34 patients with water intoxication were treated at St Louis (Mo) Children's Hospital, 24 of these in the last 3 years, indicating a marked increase in incidence of this previously rare condition. Thirty-one were infants living in poverty who ingested excessive amounts of water offered at home by their caretakers. Exhaustion of the supply of infant formula was the most common reason given for this substitution. Infants were treated by a single infusion of hypertonic saline or a slow infusion of isotonic saline. Central pontine myelinolysis was not observed as a complication of hypertonic saline therapy. Modification of the Special Supplemental Food Program for Women, Infants, and Children to provide sufficient formula for the growing infant and better education of mothers as to the hazards of excessive water ingestion might reduce the incidence of this preventable and life-threatening condition.

Disease Outbreaks↗
PubMed1990

Acute water intoxication after intranasal desmopressin in a patient with primary polydispsia.

Only a few cases of severe acute water intoxication (AWI) due to intranasal desmopressin have been reported, none of which occurred in patients with primary polydipsia. We describe a case of AWI with semicoma and convulsions, due to intranasal desmopressin, in a 32-year-old patient with dipsogenic diabetes insipidus. Previous reported cases of AWI due to desmopressin are discussed. The importance of ruling out primary polydipsia when this drug is used, not only for central diabetes insipidus but also for other current indications such as classic hemophilia, is stressed.

Administration, Intranasal↗
PubMedDate not supplied

Nursing program to meet the challenge of caring for patients with water intoxication.

This article describes a program that is effective in working with psychiatric patients who have trouble with excessive water intake. The purpose of the program is to provide consistent treatment in a controlled and therapeutic environment in which the special needs of these patients can be met. We incorporate a variety of nursing interventions suggested by the literature to help meet the goals of the program. As a result of the program, disruptive behavior has decreased and patients have learned skills to help them manage their illness. An additional benefit of the program is that working with water intoxication patients is no longer stressful for staff.

Hospital Units↗