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Volume 354:2833-2834 June 29, 2006 Number 26
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Case 8-2006: A Woman with Crohn's Disease and Altered Mental Status

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by Podolsky, D. K.
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To the Editor: Podolsky et al. (March 16 issue)1 describe a woman admitted to the hospital with a brain mass and hyponatremia (serum sodium, 131 mmol per liter). The day after admission, she had a generalized tonic–clonic seizure and required tracheal intubation. The discussants did not address the reason for this acute neurologic deterioration. The clinical picture may have been attributable to acute hospital-acquired hyponatremia. This patient was at high risk for acute neurologic deterioration from hyponatremia for a variety of reasons, including being a woman2 and having a space-occupying lesion, vasogenic cerebral edema,3 and a hypoxic event.4 Hyponatremia can . . . [Full Text of this Article]



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