Polydipsia, hyponatremia and rhabdomyolysis in schizophrenia: A case report  

作　　者：Li-Chi Chen Ya-Mei Bai Meng-Han Chang 

机构地区：[1]Department of Psychiatry, Taipei Veterans General Hospital [2]Department of Psychiatry, Collage of Medicine, National Yang-Ming University

出　　处：《World Journal of Psychiatry》2014年第4期150-152,共3页世界精神病学杂志

基　　金：Supported by Department of Psychiatry,Taipei Veterans General Hospital,Taipei,Taiwan

摘　　要：The prevalence of polydipsia among patients with schizophrenia is 6%-20%. Around 10%-20% of patients with polydipsia may develop hyponatremia and even complicated with rhabdomyolysis. Here we presented a 40-year-old man with schizophrenia, who had received paliperidone 15 mg/d for more than one year, and polydipsia was noted. In Jan, 2014, he developed hyponatremia(Na 113 m Eq/L) with consciousness disturbance. After 3% Na Cl(500 cc/d) intravenous supplement for three days, the hyponatremia was corrected, but rhabdomyolysis developed with a substantial elevation in the level of creatine kinase(CK) to 30505 U/L. After hydration, the CK level gradually decreased to 212 U/L. Both the hyponatremia itself and quick supplementation of Na Cl can cause rhabdomyolysis. If rhabdomyolysis is not recognized, insufficient hydration or water restriction for polydipsiamay further exacerbate the rhabdomyolysis with a lethal risk. In this case, we highlight the possible complication of rhabdomyolysis with polydipsia-induced hyponatremia. In addition to monitoring the serum sodium level, the monitoring of CK is also important; and switching of antipsychotic may improve the polydipsia.The prevalence of polydipsia among patients with schizophrenia is 6%-20%. Around 10%-20% of patients with polydipsia may develop hyponatremia and even complicated with rhabdomyolysis. Here we presented a 40-year-old man with schizophrenia, who had received paliperidone 15 mg/d for more than one year, and polydipsia was noted. In Jan, 2014, he developed hyponatremia(Na 113 m Eq/L) with consciousness disturbance. After 3% Na Cl(500 cc/d) intravenous supplement for three days, the hyponatremia was corrected, but rhabdomyolysis developed with a substantial elevation in the level of creatine kinase(CK) to 30505 U/L. After hydration, the CK level gradually decreased to 212 U/L. Both the hyponatremia itself and quick supplementation of Na Cl can cause rhabdomyolysis. If rhabdomyolysis is not recognized, insufficient hydration or water restriction for polydipsiamay further exacerbate the rhabdomyolysis with a lethal risk. In this case, we highlight the possible complication of rhabdomyolysis with polydipsia-induced hyponatremia. In addition to monitoring the serum sodium level, the monitoring of CK is also important; and switching of antipsychotic may improve the polydipsia.

关 键 词：SCHIZOPHRENIA POLYDIPSIA HYPONATREMIA RHABDOMYOLYSIS QUETIAPINE 

分 类 号：R749.3[医药卫生—神经病学与精神病学]