Hypernatraemia and rhabdomyolysis

A 44-year-old man with a history of childhood brain injury presented with dysarthria, confusion, reduced oral intake and reduced mobility after a week of heatwave conditions. He had severe hypernatraemia and raised serum creatine kinase levels, consistent with rhabdomyolysis. In most previous case reports linking hypernatraemia and rhabdomyolysis, other factors have potentially contributed. From the available evidence, severe hypernatraemia alone appears sufficient to induce muscle injury.

A 44-year-old man presented to a rural hospital with a 48-hour history of reduced mobility, dysarthria, confusion and reduced oral intake. He had sustained a traumatic brain injury at the age of 6 years and had intellectual impairment, mild right hemiplegia and post-traumatic epilepsy, but had not experienced a seizure for many years. Ambient temperatures were anecdotally reported to be up to 48°C during the week before presentation.