Forensic aspects of water intoxication: Four case reports and review of relevant literature

Radojević, Nemanja; Bjelogrlic, Bojana; Aleksić, Vuk; Rančić, Nemanja; Samardžić, Mira; Petković, Stojan; Savić, Slobodan

doi:10.1016/j.forsciint.2012.01.021

Cited by 29 publications

(18 citation statements)

References 27 publications

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“…Such unknown pre-existing risk factors may increase the risk of adverse events, particularly cardiovascular ones, in individuals consuming EDs, due to underlying disease. In fact, even water can be toxic given certain conditions with an LD 50 (lethal acute dose for 50 percent in test species) of greater than 90 mL/kg in rats [215]. It is possible to overdose on caffeine and there are a handful of case reports in the literature [5,209,216-218].…”

Section: Safety Considerationsmentioning

confidence: 99%

International Society of Sports Nutrition position stand: energy drinks

Campbell

Wilborn

Bounty

et al. 2013

Journal of the International Society of Sports Nutrition

181

206

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Position Statement: The International Society of Sports Nutrition (ISSN) bases the following position stand on a critical analysis of the literature on the safety and efficacy of the use of energy drinks (ED) or energy shots (ES). The ISSN has concluded the following. 1. Although ED and ES contain a number of nutrients that are purported to affect mental and/or physical performance, the primary ergogenic nutrients in most ED and ES appear to be carbohydrate and/or caffeine. 2. The ergogenic value of caffeine on mental and physical performance has been well-established but the potential additive benefits of other nutrients contained in ED and ES remains to be determined. 3. Consuming ED 10-60 minutes before exercise can improve mental focus, alertness, anaerobic performance, and/or endurance performance. 4. Many ED and ES contain numerous ingredients; these products in particular merit further study to demonstrate their safety and potential effects on physical and mental performance. 5. There is some limited evidence that consumption of low-calorie ED during training and/or weight loss trials may provide ergogenic benefit and/or promote a small amount of additional fat loss. However, ingestion of higher calorie ED may promote weight gain if the energy intake from consumption of ED is not carefully considered as part of the total daily energy intake. 6. Athletes should consider the impact of ingesting high glycemic load carbohydrates on metabolic health, blood glucose and insulin levels, as well as the effects of caffeine and other stimulants on motor skill performance. 7. Children and adolescents should only consider use of ED or ES with parental approval after consideration of the amount of carbohydrate, caffeine, and other nutrients contained in the ED or ES and a thorough understanding of the potential side effects. 8. Indiscriminant use of ED or ES, especially if more than one serving per day is consumed, may lead to adverse events and harmful side effects. 9. Diabetics and individuals with pre-existing cardiovascular, metabolic, hepatorenal, and neurologic disease who are taking medications that may be affected by high glycemic load foods, caffeine, and/or other stimulants should avoid use of ED and/or ES unless approved by their physician.

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Section: Safety Considerationsmentioning

confidence: 99%

International Society of Sports Nutrition position stand: energy drinks

Campbell

Wilborn

Bounty

et al. 2013

Journal of the International Society of Sports Nutrition

181

206

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“…Forced water ingestion has also been described as a form of child abuse [14–16]. Other more routine stressors such as jealousy from a newborn sibling have rarely been reported in the literature [17] and highlight the need for a broad differential when evaluating a toddler with polyuria and polydipsia. Our case describes a toddler who appears to come from a stable home and whose onset of symptoms developed after mom's return to work.…”

Section: Discussionmentioning

confidence: 99%

A 27-Month-Old Boy with Polyuria and Polydipsia

Lee

Winnicki

Butani

et al. 2018

Case Reports in Pediatrics

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Psychogenic polydipsia is a well-described phenomenon in those with a diagnosed psychiatric disorder such as schizophrenia and anxiety disorders. Primary polydipsia is differentiated from psychogenic polydipsia by the lack of a clear psychotic disturbance. We present a case of a 27-month-old boy who presented with polyuria and polydipsia. Laboratory studies, imaging, and an observed water deprivation test were consistent with primary polydipsia. Polydipsia resolved after family limited his fluid intake and began replacing water drinking with other transition objects and behaviors for self-soothing. This case highlights the importance of water deprivation testing to differentiate between causes of polyuria, thereby avoiding misdiagnosis and iatrogenic hyponatremia. Secondly, primary polydipsia can result during the normal stages of child development without overt psychiatric disturbances.

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“…When the amount of intracellular water increases, cellular edema develops. The cellular edema in the brain can be more dangerous than in other tissues because the brain is confined within the skull10).…”

Section: Discussionmentioning

confidence: 99%

Hyponatremia caused by excessive intake of water as a form of child abuse

Joo

Kim

2013

Ann Pediatr Endocrinol Metab

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Hyponatremia is the most common electrolyte disorder that requires careful management. Water intoxication with hyponatremia is rare condition that originated from overhydration. Water intoxication, also known as dilutional hyponatremia, develops only because the intake of water exceeds the kidney's ability to eliminate water. Causes of this water intoxication include psychiatric disorder, forced water intake as a form of child abuse and iatrogenic infusion of excessive hypotonic fluid. We experienced and reported a case of symptomatic hyponatremia by forced water intake as a form of child abuse.

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Forensic aspects of water intoxication: Four case reports and review of relevant literature

Cited by 29 publications

References 27 publications

International Society of Sports Nutrition position stand: energy drinks

International Society of Sports Nutrition position stand: energy drinks

A 27-Month-Old Boy with Polyuria and Polydipsia

Hyponatremia caused by excessive intake of water as a form of child abuse

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