Radioactive iodine treatment (RAIT) after surgery reduces local recurrence and cancer related death. Cases of hyponatremia after preparation for RAIT have rarely been reported. We report 4 cases of hyponatremia which developed after RAIT. The cause of hyponatremia seemed to be related with over ingestion of free water which is recommended during RAIT. These cases highlighted the importance of weight adjusted water ingestion during RAIT.
Eating ; Humans ; Hyponatremia* ; Iodine Radioisotopes ; Iodine* ; Recurrence ; Thyroid Gland* ; Thyroid Neoplasms* ; Water ; Water Intoxication

Hypotonic hyponatremia by primary polydipsia can cause severe neurologic complications due to cerebral edema. A 10-year-and-4-month-old boy with a psychiatric history of intellectual disability and behavioral disorders who presented with chief complaints of seizure and mental change showed severe hypotonic hyponatremia with low urine osmolality (serum sodium, 101 mmol/L; serum osmolality, 215 mOsm/kg; urine osmolality, 108 mOsm/kg). The patient had been polydipsic for a few months prior, and this had been worse in the previous few days. A diagnosis of hypotonic hyponatremia caused by primary polydipsia was made. The patient was in a coma, and developed respiratory arrest and became brain death shortly after admission, despite the treatment. The initial brain magnetic resonance imaging showed severe brain swelling with tonsillar and uncal herniation, and the patient was declared as brain death. It has been reported that antidiuretic hormone suppression is inadequate in patients with chronic polydipsia, and that this inadequate suppression of antidiuretic hormone is aggravated in patients with acute psychosis. Therefore, hyponatremia by primary polydipsia, although it is rare, can cause serious and life-threatening neurologic complications.
Brain Death* ; Brain Edema ; Brain* ; Child* ; Coma ; Diagnosis ; Humans ; Hyponatremia* ; Intellectual Disability ; Magnetic Resonance Imaging ; Male* ; Osmolar Concentration ; Polydipsia ; Polydipsia, Psychogenic* ; Psychotic Disorders ; Seizures ; Sodium ; Water Intoxication

Hyponatremia is the most common electrolyte disorder that requires careful management. Water intoxication with hyponatremia is rare condition that originated from overhydration. Water intoxication, also known as dilutional hyponatremia, develops only because the intake of water exceeds the kidney's ability to eliminate water. Causes of this water intoxication include psychiatric disorder, forced water intake as a form of child abuse and iatrogenic infusion of excessive hypotonic fluid. We experienced and reported a case of symptomatic hyponatremia by forced water intake as a form of child abuse.
Child ; Child Abuse ; Drinking ; Humans ; Hyponatremia ; Water Intoxication

Hyponatremia is the most common electrolyte disorder that requires careful management. Water intoxication with hyponatremia is rare condition that originated from overhydration. Water intoxication, also known as dilutional hyponatremia, develops only because the intake of water exceeds the kidney's ability to eliminate water. Causes of this water intoxication include psychiatric disorder, forced water intake as a form of child abuse and iatrogenic infusion of excessive hypotonic fluid. We experienced and reported a case of symptomatic hyponatremia by forced water intake as a form of child abuse.
Child ; Child Abuse ; Drinking ; Humans ; Hyponatremia ; Water Intoxication

We present a 32-year-old, extremely obese, pregnant woman who developed severe hypotension and water intoxication after an accidental injection of large bolus of oxytocin during cesarean section under general anesthesia. The patient was initially thought to have an amniotic fluid embolism because of the abrupt hemodynamic changes developed immediately after fetal delivery and lack of recognition of medication error. It is highly recommended that careful attention should be paid not only to the possibility of hemodynamic deterioration and water intoxication if oxytocin is given rapidly in excessive doses, but to the confirmation of the proper use of the drug before it is injected.
Adult ; Anesthesia, General ; Cesarean Section ; Embolism, Amniotic Fluid ; Female ; Hemodynamics ; Humans ; Hypotension ; Medication Errors ; Oxytocin ; Pregnancy ; Pregnant Women ; Water Intoxication

We report a case of fatal water intoxication in a schizophrenic patient. A 41-year-old schizophrenic male, who was admitted to a psychiatric hospital, was found dead in the restroom of the hospital. He had drunk many bowls of tap water before. On the postmortem examination, the brain was diffusely edematous, but no apparent herniation was noted. The lung was mildly expanded with edema. The stomach and intestine were diffusely expanded, and the intestine and mesentery were extensively edematous. Bilateral hydronephrosis was observed. A subcapsular hematoma with focal cortical rupture was observed in the right kidney. The vitreous sodium was 102 mEq/l and potassium was 10.5 mEq/l.
Adult ; Autopsy ; Brain ; Edema ; Hematoma ; Hospitals, Psychiatric ; Humans ; Hydronephrosis ; Intestines ; Kidney ; Lung ; Male ; Mesentery ; Potassium ; Rupture ; Sodium ; Stomach ; Water Intoxication

OBJECTIVES: The aims of this study are to estimate the prevalence of polydipsia and water intoxication and to identify risk factors of polydipsia and water intoxication in psychiatric inpatient. METHODS: 1,108 Psychiatric inpatients at 2 mental hospitals in Yongin city were studied from September, 2008 to January, 2009. We diagnosed'polydipsia' using staff reports(fluid intake>3L/day) or by specific gravity of urine(SPGU<1.008) and diagnosed'at risk for water intoxication' using normalized diurnal weight gain (NDWG>4%). We attempted to identify clinical characteristics of patients by reviewing their medical records. RESULTS: Two hundred forty seven patients(22.3%) were polydipsic. Sixty eight patients(6.1%) were at risk for water intoxication. The factors associated with polydipsia were lithium, smoking, younger age and increased smoking amounts. The factors associated with risk for water intoxication were valproic acid and polydipsia. CONCLUSION: Polydipsia and water intoxication in psychiatric inpatients are not rare conditions. Therefore, clinicians' attention should be paid to these conditions.
Hospitals, Psychiatric ; Humans ; Inpatients ; Lithium ; Polydipsia ; Prevalence ; Risk Factors ; Smoke ; Smoking ; Specific Gravity ; Valproic Acid ; Water Intoxication ; Weight Gain

Cyclophosphamide is frequently used for the treatment of severe lupus nephritis, but is very rarely associated with dilutional hyponatremia. Recently we experienced a case of water intoxication following low-dose intravenous cyclophosphamide. Five hours after one dose of intravenous pulse cyclophosphamide 750 mg, the patient developed nausea, vomiting, and general weakness. Serum sodium concentration revealed 114 mEq/L and her hyponatremia was initially treated with hypertonic saline infusion. Then her serum sodium concentration rapidly recovered to normal with water restriction alone. During the course of intravenous pulse cyclophosphamide therapy, one must be aware of the possibility of significant water retention.
Cyclophosphamide* ; Humans ; Hyponatremia ; Lupus Nephritis ; Nausea ; Sodium ; Vomiting ; Water Intoxication*

No abstract available.
Hyponatremia ; Motor Activity* ; Water Intoxication ; Weather*

Water intoxication associated with hyponatremia is a rare and sometimes fatal complication of oxytocin. We report a 18-year-old primigravida who presented with vomiting, seizures, and stuporous mental state after abortion with oxytocin infusion. The serum sodium was 116 mEq/L and serum osmolality was 234 mosm/kg. The serum sodium level as well as clinical symptoms were improved after hypertonic saline infusion. We suggest that the serum electrolytes and osmolarity should be examined in patients who presenting with seizure and altered mental state with history of labour or abortion.
Adolescent ; Electrolytes ; Humans ; Hyponatremia ; Osmolar Concentration ; Oxytocin ; Seizures* ; Sodium ; Stupor ; Vomiting ; Water Intoxication*