Hypernatremia-associated rhabdomyolysis in paediatric traumatic brain injury.
Camila Beltrán-Dimas, Monica Mondragón-Gaviria, Juan Javier Peralta-Palmezano et al.
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Case in brief
A male adolescent with severe traumatic brain injury from a motorcycle accident developed severe hypernatremia (168 mEq/L) while receiving hypertonic solutions in the ICU. This led to elevated creatine kinase levels (up to 30,197 U/L) and transient acute kidney injury. After conservative management, the patient recovered without the need for dialysis.
What made this case unusual
Severe hypernatremia as a recognized cause of rhabdomyolysis in a pediatric patient is rarely reported, particularly in the context of traumatic brain injury.
Diagnostic / clinical pearl
Clinicians should consider severe hypernatremia as a potential cause of rhabdomyolysis in pediatric patients with traumatic brain injury, monitoring renal function and creatine kinase levels closely.
Why it matters
This case emphasizes the need for vigilance in managing electrolyte disturbances in critically ill pediatric patients, as they may lead to significant complications like rhabdomyolysis.