A Rare Case of Fatal Hyponatremia Due to a Combination of Psychotropic Polypharmacy and Hypothyroidism

Musham, Chaitanya K.; Jarathi, Archana; Pedraza, Gabriel

doi:10.4088/pcc.09l00897gre

Cited by 4 publications

(2 citation statements)

References 14 publications

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“…Byramji et al [97] and Ingham and Byard [98] reviewed Unnatural cases of hyponatremia upon autopsy [97,[104][105][106][107][108][109][110][111][112][113] include water intoxication from psychogenic polydipsia, environmental polydipsia, ingestion of dilute infant formulas, beer potomania, endurance exercise, fresh water immersion and iatrogenic causes including drug and parenteral fluid administration and surgical irrigation. If antemortem findings are not available, vitreous sodium levels lower than 120 mmol/l could support the diagnosis of fatal hyponatremia [104].…”

Section: Electrolytesmentioning

confidence: 98%

Postmortem chemistry update part I

2011

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Postmortem chemistry is becoming increasingly essential in the forensic pathology routine and considerable progress has been made over the past years. Biochemical analyses of vitreous humor, cerebrospinal fluid, blood and urine may provide significant information in determining the cause of death or in elucidating forensic cases. Postmortem chemistry may essentially contribute in the determination of the cause of death when the pathophysiological changes involved in the death process cannot be detected by morphological methods (e.g. diabetes mellitus, alcoholic ketoacidosis and electrolytic disorders). It can also provide significant information and useful support in other forensic situations, including anaphylaxis, hypothermia, sepsis and hormonal disturbances. In this article, we present a review of the literature that covers this vast topic and we report the results of our observations. We have focused our attention on glucose metabolism, renal function and electrolytic disorders.

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Section: Electrolytesmentioning

confidence: 98%

Postmortem chemistry update part I

2011

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“… 8 Other common metabolic or electrolyte abnormalities within our differential included hyponatremia and hypoglycemia, which were excluded by obtaining a POC glucose and BMP. 9 Urinary tract infection, which commonly causes altered mental status in the elderly, and toxin ingestion were ruled out with normal urinalysis and a negative urine toxicology panel. 10 …”

Section: Discussionmentioning

confidence: 99%

An Unresponsive Patient in Postanesthesia Care Unit: A Case Report of an Unusual Diagnosis for a Common Problem

2020

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An unresponsive patient in the postoperative period is a serious complication that can be caused by anesthetics. However, nonanesthetic causes should also be considered. In this case report, we present an unresponsive postoperative patient diagnosed with possible psychosomatic catatonia. We further describe a systematic approach to the unresponsive patient in the postanesthesia care unit (PACU). While not an uncommon occurrence, catatonia is a complex psychomotor syndrome that can be difficult to diagnose; however, catatonia should be considered in unresponsive postoperative patients.

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Postmortem diagnosis of hyponatremia: case report and literature review

et al. 2017

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Hyponatremia is defined as a plasma sodium concentration less than 135 or 130 mEq/L (or mmol/L) and may be responsible for life threatening symptoms that can be observed in a variety of medical conditions. Cases of fatal hyponatremia have been reported in both clinical and forensic literature in situations of water intoxication due to psychogenic polydipsia, amphetamine derivative drug intake, high-endurance exercise, iatrogenic causes, and exceptional cases of child abuse by forced water intoxication. Vitreous sodium levels have been determined to be relatively stable during the early postmortem period and similar to levels found in normal serum of living subjects. Nevertheless, there are relatively few cases of fatal hyponatremia described in literature that underwent exhaustive postmortem biochemical investigations. A case of fatal water intoxication in a psychiatric patient who underwent medicolegal investigations, including postmortem biochemistry, was chosen as a starting point to a literature review of deaths by hyponatremia that may be encountered in the forensic setting.

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A Rare Case of Fatal Hyponatremia Due to a Combination of Psychotropic Polypharmacy and Hypothyroidism

Cited by 4 publications

References 14 publications

Postmortem chemistry update part I

Postmortem chemistry update part I

An Unresponsive Patient in Postanesthesia Care Unit: A Case Report of an Unusual Diagnosis for a Common Problem

Postmortem diagnosis of hyponatremia: case report and literature review

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