Severe hyponatremia and seizures after bowel preparation with low-volume polyethylene glycol plus ascorbic acid solution

이재영; Jang Byung Ik; Yoon-Jung Nam; Jay Song; 김민철; Seung Min Chung; 장종걸; Cho Jae Ho

doi:https://doi.org/10.12701/yujm.2015.32.1.55

Severe hyponatremia and seizures after bowel preparation with low-volume polyethylene glycol plus ascorbic acid solution

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저용량 polyethylene glycol 용액에 아스코르빈산을 첨가한 장정결제로 대장내시경 전처치 후 발생한 발작을 동반한 저나트륨혈증

Type: Academic journal

Author: 이재영 (영남대학교) Jang Byung Ik (영남대학교) Yoon-Jung Nam (영남대학교) Jay Song (영남대학교) 김민철 (영남대학교) Seung Min Chung (영남대학교) 장종걸 (영남대학교) Cho Jae Ho (영남대학교)

Journal: 영남대학교 의과대학 Journal of Yeungnam Medical Science Journal of Yeungnam Medical Science 제32권 제1호 KCI Accredited Journals

Published: 2015.6

Pages: 55 - 59 (5page)

DOI: https://doi.org/10.12701/yujm.2015.32.1.55

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Severe hyponatremia and seizures after bowel preparation with low-volume polyethylene glycol plus ascorbic acid solution

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The widely used polyethylene glycol (PEG)-based solutions have been proven effective for bowel preparation when 4 L of the solution is administered before colonoscopy. However, large volumes of the solutions are generally poorly tolerated. A new PEG-based solution consisting of 2 L of PEG and a high dose of ascorbic acid has recently become available. Electrolyte abnormalities caused by PEG-based solutions have rarely been reported. We report on a case of acute severe hyponatremia with associated generalized tonic-clonic seizures after bowel preparation with a low-volume PEG plus ascorbic acid solution in a 74-year-old woman with no history of seizures. She took a beta blocker, an angiotensin-converting enzyme inhibitor, and glimepiride for hypertension and diabetes mellitus. She showed general weakness, nausea, agitation, muscle cramping, and seizures after ingestion of the PEG plus ascorbic acid solution. Her serum sodium level was 112 mEq/L. Her symptoms improved after intravenous administration of hypertonic saline. Physicians should pay attention to screening for electrolytes and development of neurological symptoms during bowel preparation.

#Polyethylene glycol #Bowel preparation #Hyponatremia #Seizure

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Belsey J / 2007 / Systematic review: oral bowel preparation for colonoscopy / Aliment Pharmacol Ther 25:373~384

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최경숙 / 2005 / 대장내시경 전처치 후 발생한 저나트륨혈증 3예 / Kidney Research and Clinical Practice 24(2):295~299

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