うつ病性昏迷により高ナトリウム血症を呈した1例

Abstract

Hyponatremia is well known to be caused by water intoxication, but there are few reports on hypernatremia induced by mental disorder. We report a rare case of secondary hypernatremia caused by depressive stupor. The patient (a 57-year- old female) refused to eat, drink or speak due to depressive stupor. As a result, she suffered from hypohydremia with hypernatremia (serum sodium 157mEq/l, urea nitrogen 114mg/dl), and was admitted to our psychiatric ward. She was treated with infusion (hypoosmosis) and antidepressants (mainly clomipramine). Her depressive stupor and hypernatremia were gradually improved. Generally, hypernatremia results from water depletion, disturbance of consciousness, or adipsia due to organic brain syndrome. Furthermore, the possibility exists that mental disorder induces secondary hypernatre- mia. In the case of a patient with hypernatremia, secondary influences induced by mental disorder need to be considered.