One case of hyponatremia encephalopathy caused by compound polyethylene glycol electrolyte powder (Ⅱ)

doi:10.19803/j.1672-8629.20220225

Abstract

Abstract: Objective To explore the clinical characteristics, diagnosis and treatment of hyponatremia caused by compound polyethylene glycol electrolyte powder (Ⅱ) . Methods One case of hyponatremia caused by compound polyethylene glycol electrolyte powder (Ⅱ) was analyzed, and the related literature was summarized. Results A 62-year-old lady was hospitalized for colonoscopy due to “colonic polyps”. She drank 4 bags (68.56 g/bag) of compound polyethylene glycol electrolyte powder (Ⅱ) dissolved in 4 000 mL of warm water. Eighteen hours after treatment, the patient lost consciousness and developed convulsion of the right lower limb and urinary incontinence. Quick examination showed that blood sodium was 114 mmol·L^-1. Plain CT scan of the head revealed global brain edema so that the patient was diagnosed with hyponatremia encephalopathy. After 5 hours of symptomatic treatment, the patient opened her eyes without speaking. On the third day, the patient regained consciousness, blood electrolytes returned to normal, and there were no more limb convulsions. Conclusion After polyethylene glycol powder is prescribed, clinicians should pay attention to the changes of electrolytes and other clinical complications.

Key words: polyethylene glycol electrolyte powder (Ⅱ), hyponatremia encephalopathy, epilepsy, electrolyte, low sodium, low potassium, adverse drug reaction

CLC Number:

R994.11

XIE Anjie, WANG Changde, CHEN Hui, ZHANG Shiqiang. One case of hyponatremia encephalopathy caused by compound polyethylene glycol electrolyte powder (Ⅱ)[J]. Chinese Journal of Pharmacovigilance, 2023, 20(6): 709-711.

References

[1] ZHANG YY, NIU M, WU ZY, et al.The incidence of and risk factors for inadequate bowel preparation in elderly patients: A prospective observational study:a prospective observational study[J]. Saudi Gastroenterol, 2018, 24(2): 87-92.
[2] CHEN PS, MA ZJ, ZHANG HS, et al.Analysis of influencing factors of poor intestinal preparation in elderly patients undergoing colonoscopy[J]. Modern Digestion & Intervention(现代消化及介入诊疗), 2017, 22(3): 358-360.
[3] AYUS JC, LEVINE R, ARIEFF AI.Fatal dysnatraemia caused by elective colonoscopy[J]. BMJ, 2003, 326: 382-384.
[4] MA YY, CHEN ZB, WANG Y.Hyponatremia encephalopathy caused by compound polyethylene glycol electrolytes powder (Ⅲ)[J]. Adverse Drug Reactions Journal(药物不良反应杂志), 2021, 23(3): 163-164.
[5] LEE SH, CHA JM, LEE JL, et al.Anaphylactic shock caused by ingestion of polyethylene glycol[J]. Intestinal Research, 2015, 13(1): 90-94.
[6] XI M, SHI SQ, GAO J, et al.Electrolyte disorder, metabolic acidosis, and hyponatremia encephalopathy caused by polyethylene glycol electrolytes powder (Ⅳ)[J]. Adverse Drug Reactions Journal(药物不良反应杂志), 2020, 22(4): 270-271.
[7] COHEN CD, KEUNEKE C, SCHIEMANN U, et al.Hyponatraemia as a complication of colonoscopy[J] . Lancet, 2001, 357: 282-283.
[8] WINDPESSL M, SCHWARZ C, WALLNER M.“Bowel prep hyponatremia” - a state of acute water intoxication facilitated by low dietary solute intake: case report and literature review[J]. BMC Nephrology, 2017, 18(1): 54.
[9] HSU YJ, CHIU JS, LU KC, et al.Biochemical and etiological characteristics of acute hyponatremia in the emergency department[J]. Journal of Emergency Medicine, 2005, 29(4): 369-374.
[10] HU P.Observation on the effect of patients taking compound polyethylene glycol electrolyte powder solution once and several times before colonoscopy[J]. Shanxi Medicine Journal(山西医药杂志), 2022, 51(4): 406-408.
[11] LI Q, WANG DD, ZHOU Y, et al.Effect of actual medication speed of compound polyethylene glycol electrolyte powder on intestinal preparation[J]. Modern Digestion & Intervention(现代消化及介入诊疗), 2021, 26(10): 1220-1224, 1229.
[12] ZHU LL, YANG H, YANG AM.Research progress of compound polyethylene glycol electrolyte powder in intestinal preparation before colonoscopy[J]. Beijing Medicine Journal(北京医学), 2021, 43(11): 1117-1119.
[13] JIAO L, MA H, FAN X, et al.Effect of modified compound polyethylene glycol electrolyte powder on intestinal cleaning effect and patient compliance in intestinal preparation for colonoscopy[J]. Journal of Clinical and Experimental Medicine(临床和实验医学杂志), 2021, 20(23): 2551-2554.
[14] ZHOU SY, JIN Y.Effect of dimethylsilicone oil combined with compound polyethylene glycol on the detection rate of colonic polyps[J]. Chinese Journal of Digestive Endoscopy(中华消化内镜杂志), 2021, 38(12): 1025-1028.
[15] LI CX, GUO Y, ZHU YJ, et al.Comparison of polyethylene glycol versus lactulose oral solution for bowel preparation prior to colonoscopy[J]. Gastroenterology Research and Practice, 2019, 2019:1-6.
[16] HU YC, LI XP, LIN T, et al.The advantage of polyethylene glycol electrolyte solution combined with lactulose in patients with long interval preparation-to-colonoscopy[J]. Turk J Gastroenterol, 2020, 31(1): 23-29.
[17] YU HC, HUANG FC, WU SM.Application effect of compound polyethylene glycol electrolyte powder combined with rhubarb acupoint application in intestinal preparation of patients undergoing painless colonoscopy[J]. Journal of Clinical Rational Drug Use(临床合理用药杂志), 2022, 15(6): 96-98.