Cargando…

Salt Poisoning Due to Inadequate Infant Formula Preparation: A Rare Cause of Hypernatremia and Massive Cerebral Hemorrhage in a Newborn

Salt poisoning is a rare cause of severe hypernatremia in children resulting from the ingestion of toxic amounts of sodium chloride, either from accidental or intentional administration of salted solutions. We present the case of a newborn admitted to a pediatric emergency department for lethargy an...

Descripción completa

Detalles Bibliográficos
Autores principales: Kakoo Brioso, Estela, Moscoso, Joana, Vieira, Filipa, Salazar, Anabela, Tuna, Madalena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9881600/
https://www.ncbi.nlm.nih.gov/pubmed/36721612
http://dx.doi.org/10.7759/cureus.33045
_version_ 1784879140899389440
author Kakoo Brioso, Estela
Moscoso, Joana
Vieira, Filipa
Salazar, Anabela
Tuna, Madalena
author_facet Kakoo Brioso, Estela
Moscoso, Joana
Vieira, Filipa
Salazar, Anabela
Tuna, Madalena
author_sort Kakoo Brioso, Estela
collection PubMed
description Salt poisoning is a rare cause of severe hypernatremia in children resulting from the ingestion of toxic amounts of sodium chloride, either from accidental or intentional administration of salted solutions. We present the case of a newborn admitted to a pediatric emergency department for lethargy and reduced oral intake; his laboratory evaluation showed severe hypernatremia ([Na(+)] of 174 mmol/L). The infant developed convulsive status epilepticus during treatment. Neuroimaging showed a tetraventricular hemorrhage, a large right-sided parenchymal hemorrhage with midline shift, and several left hemorrhagic foci. Etiologic evaluation for hypernatremia did not reveal a renal or extrarenal source of water loss nor an intercurrent illness to explain the reduced oral intake. A careful review of how the parents prepared the infant formula revealed an error in dosing the ratio of powder/water, resulting in hyperosmolar infant formula. The infant was diagnosed with salt poisoning as the major cause of hypernatremia. After careful correction of hypernatremia and the use of antiseizure medication, the patient improved and was discharged. The parents were given a careful review of instructions for infant formula preparation. Due to its rarity, a high index of suspicion is mandatory for a correct diagnosis of salt poisoning. Timely and adequate treatment is needed due to the high risk of intracerebral bleeding, seizures, and irreversible neurologic injury. Children, particularly newborns and infants, depend upon adults to ingest water and, thus, have more difficulty in maintaining electrolyte balance. Therefore, it is of utmost importance that parents are educated about childcare, particularly on the importance of careful infant formula preparation.
format Online
Article
Text
id pubmed-9881600
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Cureus
record_format MEDLINE/PubMed
spelling pubmed-98816002023-01-30 Salt Poisoning Due to Inadequate Infant Formula Preparation: A Rare Cause of Hypernatremia and Massive Cerebral Hemorrhage in a Newborn Kakoo Brioso, Estela Moscoso, Joana Vieira, Filipa Salazar, Anabela Tuna, Madalena Cureus Pediatrics Salt poisoning is a rare cause of severe hypernatremia in children resulting from the ingestion of toxic amounts of sodium chloride, either from accidental or intentional administration of salted solutions. We present the case of a newborn admitted to a pediatric emergency department for lethargy and reduced oral intake; his laboratory evaluation showed severe hypernatremia ([Na(+)] of 174 mmol/L). The infant developed convulsive status epilepticus during treatment. Neuroimaging showed a tetraventricular hemorrhage, a large right-sided parenchymal hemorrhage with midline shift, and several left hemorrhagic foci. Etiologic evaluation for hypernatremia did not reveal a renal or extrarenal source of water loss nor an intercurrent illness to explain the reduced oral intake. A careful review of how the parents prepared the infant formula revealed an error in dosing the ratio of powder/water, resulting in hyperosmolar infant formula. The infant was diagnosed with salt poisoning as the major cause of hypernatremia. After careful correction of hypernatremia and the use of antiseizure medication, the patient improved and was discharged. The parents were given a careful review of instructions for infant formula preparation. Due to its rarity, a high index of suspicion is mandatory for a correct diagnosis of salt poisoning. Timely and adequate treatment is needed due to the high risk of intracerebral bleeding, seizures, and irreversible neurologic injury. Children, particularly newborns and infants, depend upon adults to ingest water and, thus, have more difficulty in maintaining electrolyte balance. Therefore, it is of utmost importance that parents are educated about childcare, particularly on the importance of careful infant formula preparation. Cureus 2022-12-28 /pmc/articles/PMC9881600/ /pubmed/36721612 http://dx.doi.org/10.7759/cureus.33045 Text en Copyright © 2022, Kakoo Brioso et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Pediatrics
Kakoo Brioso, Estela
Moscoso, Joana
Vieira, Filipa
Salazar, Anabela
Tuna, Madalena
Salt Poisoning Due to Inadequate Infant Formula Preparation: A Rare Cause of Hypernatremia and Massive Cerebral Hemorrhage in a Newborn
title Salt Poisoning Due to Inadequate Infant Formula Preparation: A Rare Cause of Hypernatremia and Massive Cerebral Hemorrhage in a Newborn
title_full Salt Poisoning Due to Inadequate Infant Formula Preparation: A Rare Cause of Hypernatremia and Massive Cerebral Hemorrhage in a Newborn
title_fullStr Salt Poisoning Due to Inadequate Infant Formula Preparation: A Rare Cause of Hypernatremia and Massive Cerebral Hemorrhage in a Newborn
title_full_unstemmed Salt Poisoning Due to Inadequate Infant Formula Preparation: A Rare Cause of Hypernatremia and Massive Cerebral Hemorrhage in a Newborn
title_short Salt Poisoning Due to Inadequate Infant Formula Preparation: A Rare Cause of Hypernatremia and Massive Cerebral Hemorrhage in a Newborn
title_sort salt poisoning due to inadequate infant formula preparation: a rare cause of hypernatremia and massive cerebral hemorrhage in a newborn
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9881600/
https://www.ncbi.nlm.nih.gov/pubmed/36721612
http://dx.doi.org/10.7759/cureus.33045
work_keys_str_mv AT kakoobriosoestela saltpoisoningduetoinadequateinfantformulapreparationararecauseofhypernatremiaandmassivecerebralhemorrhageinanewborn
AT moscosojoana saltpoisoningduetoinadequateinfantformulapreparationararecauseofhypernatremiaandmassivecerebralhemorrhageinanewborn
AT vieirafilipa saltpoisoningduetoinadequateinfantformulapreparationararecauseofhypernatremiaandmassivecerebralhemorrhageinanewborn
AT salazaranabela saltpoisoningduetoinadequateinfantformulapreparationararecauseofhypernatremiaandmassivecerebralhemorrhageinanewborn
AT tunamadalena saltpoisoningduetoinadequateinfantformulapreparationararecauseofhypernatremiaandmassivecerebralhemorrhageinanewborn