Author/Editor     Kanič, Zlatka; Puklavec, Evelin; Osterc Koprivšek, Andreja; Miksić, Mirjana; Štelcar, Andreja
Title     Zastrupitev z vodo pri otrocih in prikaz primera
Translated title     Water intoxication in children and case report
Type     članek
Source     In: Bolezni in simptomi otrok kot odraz slabega družinskega ravnotežja Genetika v pediatriji Zastrupitve pri otrocih : zbornik predavanj Maribor : Univerzitetni klinični center
Publication year     2013
Volume     str. 141-145
Language     slv
Abstract     Zastrupitev z vodo (ZV) je redka bolezen, ki jo pri odraslih opisujejo predvsem pri psihiatričnih bolnikih. V otroštvu je ZV značilna za male otroke, ki imajo psihogeno polidipsijo ali pri duševno hudo zaostalih otrocih. V prispevku opisujemo 22 mesečno bolnico, ki so jo pripeljali v bolnišnico po generaliziranih tonično - kloničnih krčih z izgubo zavesti. Kmalu po sprejemu se je napad ponovil v enaki obliki. Napad smo prekinili z zdravili (diazepam rektalno, nato lorazepam v maksimalnem odmerku). Zaradi anamneze o poškodbi glave je bil opravljen CT možganov, ki ni pokazal sprememb. Laboratorijski izvidi so potrdili hipoosmolarno hiponatremijo. Mama je povedala, da je deklica pred prvim napadom spila ogromno čaja in da tudi sicer svojo stisko tolaži s pitjem čaja. Deklici smo omejili vnos tekočine na zanjo primerno fiziološko prostornino, prvih 16 ur pa smo ji dodali malo natrija. S takim zdravljenjem smo bili uspešni: konvulzije se niso ponovile, natrij in osmolarnost seruma sta se normalizirala in ni prišlo do rabdomiolize. Ob odpustu domov smo mamo poučili o vzroku krčev in jo opozorili na nujnost omejitve vnosa tekočine. Prav tako je nujno, da se o dekličinih nagnjenjih poučijo vsi skrbniki, ki ji ne smejo dovoliti pitja neomejenih količin tekočine.Water intoxication is a rare disease, in the adult population seen predominantly in psychiatric patients. In childhood it is characteristic of small children with psychogenic polydipsia or those with severe mental retardation. This article presents a 22-month old girl, who was admitted to our hospital after generalised tonic-clonic seizures with loss of consciousness. Shortly after admission she suffered another identical seizure, which was treated with rectal diazepam and lorazepam in maximum doses. Because of a history of head injury, a CT scan of the brain was performed, which did not reveal any changes. The laboratory results confirmed a hypo - osmolar hyponatremia. The mother said that the girl drank a huge quantity of tea before the first seizure and that this is her normal behaviour in any kind of distress. The girl was treated with fluid restriction to physiological amounts, with the addition of small amounts of sodium in the first 16 hours. The treatment was successful - there were no further seizures, sodium and serum osmolality normalised, and no rhabdomyolysis occurred. At discharged, her mother was educated about the aetiology of her seizures and the importance of limiting her water intake. In addition, all of the girl`s caregivers must be instructed not to allow her to drink unlimited quantities of liquids.
Descriptors     Water
Voda
Child
Otrok
Poisoning
Zastrupitev