J Korean Soc Emerg Med.  2007 Jun;18(3):263-266.

A case Report of Hyponatremia Resulting from Treatment of Anaphylaxis and Rhabdomyolysis in a Snake Bite Patient

• Kim SP
• Yoon DH
• Kim SJ
• Cho SH
• Cho NS

Abstract

Hyponatremia is a condition of body fluid and electrolyte imbalance frequently encountered in clinical practice. However, treatment with small amounts of furosemide has in rare instances been reported to be associated with hyponatremia. We report a case of a 50-years-old woman who developed symptomatic hyponatremia after treatment for anaphylaxis and rhabdomyolysis resulting from snake bite. The woman was presented with hypotension and hypersensitivity induced by administration of antivenom after a snake bite. She was treated by fluid therapy and administration of epinephrine. One day after hospitalization, she complained of abdominal pain, and her myoglobin level and creatine phosphokinase concentration had increased. She was treated with hydration and urine alkalization. Renal failure and compartment syndrome were not complications of the clinical course. However, pleural effusion and ascites developed following fluid therapy. A small amount of furosemide was administered for treatment, and one day after administration, hyponatremia was found to have developed. The possibility of prescribing a small amout furosemide should be considered for patients who are treated with fluid therapy and require administration of antivenom for anaphylaxis and rhabdomyolysis resulting from snake bite.

Keyword

Hyponatremia; Anaphylactic shock; Rhabdomyolysis; Snake bite

MeSH Terms

Abdominal Pain
Anaphylaxis*
Ascites
Body Fluids
Compartment Syndromes
Creatine Kinase
Epinephrine
Female
Fluid Therapy
Furosemide
Hospitalization
Humans
Hypersensitivity
Hyponatremia*
Hypotension
Myoglobin
Pleural Effusion
Renal Insufficiency
Rhabdomyolysis*
Snake Bites*
Snakes*
Creatine Kinase
Epinephrine
Furosemide
Myoglobin