Hypertonic saline versus fluid restriction: The pitfalls in managing acute hyponatremia in a patient with long-standing spinal cord injury

Vaios Koutroukas; Panagiotis Pavlou; Emilia Imogen Smith; Andra Maria Ciutac; Christopher Redford; Jamie C Smith

doi:10.1002/ccr3.6576

Hypertonic saline versus fluid restriction: The pitfalls in managing acute hyponatremia in a patient with long-standing spinal cord injury

Clin Case Rep. 2022 Dec 2;10(12):e6576. doi: 10.1002/ccr3.6576. eCollection 2022 Dec.

Authors

Vaios Koutroukas^{1

2}, Panagiotis Pavlou^{1

3}, Emilia Imogen Smith⁴, Andra Maria Ciutac⁴, Christopher Redford¹, Jamie C Smith¹

Affiliations

¹ Diabetes and Endocrinology Department Torbay and South Devon NHS Foundation Trust Torquay UK.
² Present address: Royal Devon University Healthcare NHS Foundation Trust Exeter UK.
³ Present address: Wexham Park Hospital, Frimley Health NHS Foundation Trust Slough UK.
⁴ Faculty of Biology, Medicine and Health University of Manchester Manchester UK.

Abstract

Spinal cord injury-induced hyponatremia is an under-recognized entity, without a mention in the European hyponatremia guidelines. We present a case of a 56-year-old female quadraplegic patient with cervical cord injury, presenting with severe hyponatremia and tonic-clonic seizures. This case highlights the challenges in medical management; action mechanisms are further discussed.

Keywords: antidiuresis; fluid restriction; hyponatremia; spinal cord injury.

Publication types

Case Reports