Distinguishing between salt poisoning and hypernatraemic dehydration in children

摘要

The criteria most widely used to diagnose salt poisoning in children were formulated by Meadow. These criteria focus on hypernatraemia with high urinary concentrations of sodium and chloride, but this combination may also be found in children with dehydration caused by diarrhoea. The medical and legal management of the two conditions fundamentally are different, so reliable ways to distinguish them are needed. We consider the physiology of salt overload and hypernatraemic dehydration." We explain how to differentiate the two situations on the basis of history; examination; and biochemical analysis of serial, paired, blood, and "spot" urine samples. We illustrate the method with two cases that have been tested in court.