Gözde AYDIN BUMİN, Kadriye KAHVECİ, Dilşen ÖRNEK, M. A. BİLGİÇ, Avni DİNÇ, Gülten ÖZGÜN

Symptomatic hyponatremia associated with psychogenic plidipsia

Giriş: Psikojenik veya primer polidipsi aşırı derecede susama ve kompulsif su içme ile giden psikiatrik hastalarda %6'dan %20'ye kadar sıklıkta olan bir problemdir. Hiponatremi semptomları artmış psikotik semptomlardan nöbetlere, koma, hatta ölüme sebebiyet verebilir. Olgu: Yirmibir yaşındaki erkek hasta acil servise bilinç kaybı ile başvurdu. Labaratuvar testlerinde 117 mmol l'1 hiponatremisi olduğu ortaya çıktı. Hipofiz tümörü, paraneoplastik sendrom ve uygunsuz ADH sekresyonu gibi hiponatremi oluşturabilecek etyolojik sebepler yapılan testlerle ortadan kaldırıldı. Psikiatrik muayenesinde hastaya psikojenik polidipsi tanısı koyuldu. Hastanın 3 günlük tedavisi sonrası psikiatrik ilaçları ve ayaktan davranışsal tedavi yöntemi önerilerek 141 mmol l' Na değeri ile taburcu edildi. Sonuç: Semptomatik hiponatremi hastalarında, baş ağrısından ensefalopatiye hatta ölüme kadar semptom verebildiğinden psikojenik polidipsi akılda tutulmalıdır. Medikal ve davranışsal tedavinin bu sendromun tedavisinde önemi büyüktür.

Psikojenşk polidipsiye bağlı semptomatik hiponatremi

Introduction: Psychogenic or primary polidipsia characterized by excessive thirst and compulsive water drinking is a common problem among psychiatric populations, affecting 6% to 20% of patients. Symptoms of hyponatremia may range from increased psychotic symptoms to seizures, coma and even death. Case: A 21 year old male patient referred to emergency unit of our hospital with loss of consciousness. In his labaratory tests showed that he had hyponatremia 117 mmol L'. Medical testing ruled out all medical conditions known to be etiologically related to hyponatremia including pituitary tumor, paraneoplastic syndrome and syndrome of inappropriate antidiuretic hormone. In his psychiatric assesment, he was diagnosed with Psychogenic Polidipsia. After 3 days of hospitalization, he was discharged with serum sodium of 141 mmol L1 with his psychiatric drugs and outpatient behavioral treatment was suggested. Conclusion: Psychogenic polydipsia should be kept in mind in symptomatic hyponatremia patients with a variety of symptoms ranging from headache to encephalopathy or even death. Medical and behavioral treatments both have importance for treatment of this syndrome.

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