Skip to main content
British Journal of Sports Medicine logoLink to British Journal of Sports Medicine
. 1998 Sep;32(3):257–258. doi: 10.1136/bjsm.32.3.257

Iatrogenic acute hyponatraemia in a college athlete

R Herfel, C K Stone, S I Koury, J J Blake
PMCID: PMC1756102  PMID: 9773179

Abstract

Hyponatraemia is one of the most common electrolyte abnormalities, leading to significant morbidity and mortality. In the most basic sense, hyponatraemia can be due to sodium loss or fluid excess. The extracellular fluid status is used to clinically divide hyponatraemia into three categories to help to determine both the cause and treatment required. Hyponatraemic patients can be categorised on the basis of their fluid status as hypovolaemic, euvolaemic, or hypervolaemic. Another distinction to make in evaluating hyponatraemia is whether the onset was acute or chronic in nature. The case presented here is iatrogenic acute hypervolaemic hyponatraemia in a college athlete. The patient presented in respiratory distress with an altered mental status after the administration of hypotonic fluids for treatment of muscle cramps. Treatment included intubation, water restriction, and furosemide, to which he responded favourably. Hyponatraemia should be in the differential diagnosis for patients presenting after intravenous fluid administration. 




Full Text

The Full Text of this article is available as a PDF (74.5 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Agre J. C. Hamstring injuries. Proposed aetiological factors, prevention, and treatment. Sports Med. 1985 Jan-Feb;2(1):21–33. doi: 10.2165/00007256-198502010-00003. [DOI] [PubMed] [Google Scholar]
  2. Arieff A. I. Management of hyponatraemia. BMJ. 1993 Jul 31;307(6899):305–308. doi: 10.1136/bmj.307.6899.305. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Brandser E. A., el-Khoury G. Y., Kathol M. H., Callaghan J. J., Tearse D. S. Hamstring injuries: radiographic, conventional tomographic, CT, and MR imaging characteristics. Radiology. 1995 Oct;197(1):257–262. doi: 10.1148/radiology.197.1.7568833. [DOI] [PubMed] [Google Scholar]
  4. Fernbach S. K., Wilkinson R. H. Avulsion injuries of the pelvis and proximal femur. AJR Am J Roentgenol. 1981 Sep;137(3):581–584. doi: 10.2214/ajr.137.3.581. [DOI] [PubMed] [Google Scholar]
  5. HOWARD F. M., PIHA R. J. FRACTURES OF THE APOPHYSES IN ADOLESCENT ATHLETES. JAMA. 1965 Jun 7;192:842–844. doi: 10.1001/jama.1965.03080230048012. [DOI] [PubMed] [Google Scholar]
  6. Höjer J. Management of symptomatic hyponatraemia: dependence on the duration of development. J Intern Med. 1994 May;235(5):497–501. doi: 10.1111/j.1365-2796.1994.tb01110.x. [DOI] [PubMed] [Google Scholar]
  7. Kujala U. M., Orava S. Ischial apophysis injuries in athletes. Sports Med. 1993 Oct;16(4):290–294. doi: 10.2165/00007256-199316040-00006. [DOI] [PubMed] [Google Scholar]
  8. MARTIN T. A., PIPKIN G. Treatment of avulsion of the ischial tuberosity. Clin Orthop. 1957;10:108–118. [PubMed] [Google Scholar]
  9. Metzmaker J. N., Pappas A. M. Avulsion fractures of the pelvis. Am J Sports Med. 1985 Sep-Oct;13(5):349–358. doi: 10.1177/036354658501300510. [DOI] [PubMed] [Google Scholar]
  10. Miller A., Stedman G. H., Beisaw N. E., Gross P. T. Sciatica caused by an avulsion fracture of the ischial tuberosity. A case report. J Bone Joint Surg Am. 1987 Jan;69(1):143–145. [PubMed] [Google Scholar]
  11. Mulloy A. L., Caruana R. J. Hyponatremic emergencies. Med Clin North Am. 1995 Jan;79(1):155–168. doi: 10.1016/s0025-7125(16)30089-x. [DOI] [PubMed] [Google Scholar]
  12. Oh M. S., Carroll H. J. Disorders of sodium metabolism: hypernatremia and hyponatremia. Crit Care Med. 1992 Jan;20(1):94–103. doi: 10.1097/00003246-199201000-00021. [DOI] [PubMed] [Google Scholar]
  13. Orava S., Kujala U. M. Rupture of the ischial origin of the hamstring muscles. Am J Sports Med. 1995 Nov-Dec;23(6):702–705. doi: 10.1177/036354659502300612. [DOI] [PubMed] [Google Scholar]
  14. Poulsen T. K., Enggaard T. P. Afrivningsfraktur af tuber ischiadicum. En sjaelden laesion hvor tidlig diagnose og korrekt behandling kan forhindre senfolger. Ugeskr Laeger. 1995 Oct 30;157(44):6140–6141. [PubMed] [Google Scholar]
  15. Pruner R. A., Johnston C. E., 2nd Avulsion fracture of the ischial tuberosity. Orthopedics. 1990 Mar;13(3):357–358. doi: 10.3928/0147-7447-19900301-17. [DOI] [PubMed] [Google Scholar]
  16. Schlonsky J., Olix M. L. Functional disability following avulsion fracture of the ischial epiphysis. Report of two cases. J Bone Joint Surg Am. 1972 Apr;54(3):641–644. [PubMed] [Google Scholar]
  17. Sterns R. H. The management of hyponatremic emergencies. Crit Care Clin. 1991 Jan;7(1):127–142. [PubMed] [Google Scholar]
  18. Sundar M., Carty H. Avulsion fractures of the pelvis in children: a report of 32 fractures and their outcome. Skeletal Radiol. 1994 Feb;23(2):85–90. doi: 10.1007/BF00563198. [DOI] [PubMed] [Google Scholar]
  19. Wootton J. R., Cross M. J., Holt K. W. Avulsion of the ischial apophysis. The case for open reduction and internal fixation. J Bone Joint Surg Br. 1990 Jul;72(4):625–627. doi: 10.1302/0301-620X.72B4.2380217. [DOI] [PubMed] [Google Scholar]

Articles from British Journal of Sports Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES