Bandar Alqahtani, M A Maleque Molla, Faisal M Alshiban
Background: Hypernatremia due to salt poisoning is clinically rare and standard care procedures have not been established. We report this case of pediatric salt poisoning due to chronic craving for table salt. Immediate recognition of salt toxicity and aggressive resuscitative measures are critical in the treatment of this lethal poisoning. Despite heroic measures, pediatric deaths due to salt toxicity still occur from irreversible neurological damage.
Case presentation: A 6-year-old boy presented to our pediatric emergency department referred from other hospital with fatigue, polyuria and polydipsia and remarkable hypernatremia with a serum sodium concentration of 203 mmol/L. The initial lab work showed blood glucose 5.7 mmol/l, Serum Sodium (203 mmol/l) from referring hospital) and venous blood gases showed PH 7.26 PCO2 47 mmHg HCO3 21.5 mmol/l. We reduced his serum sodium level slowly over 84 hours, as its toxicity happened over a period of 2 months.
Conclusion: After reviewing instances of resuscitation following salt intoxication, aggressive rapid correction of serum sodium concentration should only be considered in acute phases of hypernatremia within a few hours from ingestion.