Sodium picosulfate/magnesium citrate (Picolight Powder), which is used as a bowel preparation for the colon and the rectum, can cause a severe electrolyte imbalance like hyponatremia. When hyponatremia gets severe or occurs rapidly, it can lead to death due to associated complications. We have experienced a case of hyponatremia associated with seizure and loss of consciousness in a 76-year-old woman, who took sodium picosulfate/magnesium citrate as a bowel preparation for colonoscopy. She was taking thiazide and synthroid for the treatment of hypertension and hypothyroidism, respectively, and she had other underlying medical conditions such as a history of seizure and dementia. Following the diagnosis of hyponatremia, we used an intravenous injection of 3% NaCl to normalize the sodium level in her serum, and her associated symptoms soon disappeared.

Citations

Citations to this article as recorded by  

• Using the Cardiac–Electrophysiological Balance Index to Predict Arrhythmia Risk After Colonoscopy
  Seyit Ali Volkan Polatkan, Seyda Gunay-Polatkan, Ozgen Isik, Deniz Sigirli
  Medicina.2024; 61(1): 13.     CrossRef
• Hyponatremia‐induced generalized seizure after taking polyethylene glycol for colon preparation—A case report and brief review of the literature
  Shiva Seyrafian, Vahid Sebghatollahi, Bahar Bastani
  Clinical Case Reports.2022;[Epub]     CrossRef
• Hyponatremic Seizure after Ingestion of an Oral Sulfate Tablet for Bowel Preparation for Colonoscopy
  Sung Hyun Hong, Dong Seok Lee, Ji Won Kim, Kook Lae Lee, Hyoun Woo Kang, Su Hwan Kim
  The Korean Journal of Gastroenterology.2022; 80(3): 154.     CrossRef
• Seizure from water intoxication following bowel preparation: a case report
  Ting-Hsuan Chiang, Jui-Hsiang Tan, Chun-Chao Chang, Kuan-Chieh Fang
  BMC Nephrology.2022;[Epub]     CrossRef
• Severe symptomatic hyponatraemia secondary to bowel preparation
  Krishan Pratap, Manasi Jiwrajka, Liam Weber, Alan Richardson
  BMJ Case Reports.2019; 12(10): e230385.     CrossRef
• Preparation for colonoscopy: Recommendations by an expert panel in Italy
  Cristiano Spada, Renato Cannizzaro, Maria Antonietta Bianco, Rita Conigliaro, Emilio Di Giulio, Cesare Hassan, Riccardo Marmo, Pietro Occhipinti, Franco Radaelli, Alessandro Repici, Enrico Ricci, Guido Costamagna
  Digestive and Liver Disease.2018; 50(11): 1124.     CrossRef
• Severe hyponatremia secondary to preparation for colonoscopy with sodium picosulfate/magnesium citrate
  Olatz Azcune Echeverria
  Revista Española de Enfermedades Digestivas.2018;[Epub]     CrossRef
• “Bowel prep hyponatremia“ – a state of acute water intoxication facilitated by low dietary solute intake: case report and literature review
  Martin Windpessl, Christoph Schwarz, Manfred Wallner
  BMC Nephrology.2017;[Epub]     CrossRef
• Severe Hyponatremia with Mental Change after Ingestion of Picosulfate Sodium/Magnesium Citrate for Bowel Preparation
  Woojung Kim, Sang Young Park, Mi Jeoung Kim, Hyang Mo Koo
  The Korean Journal of Medicine.2016; 91(2): 206.     CrossRef
• Upper airway obstruction resulting from acute mucosal injury induced by direct ingestion of sodium picosulfate/magnesium citrate powder
  Gyeong Bo Kim, Sung Yeon Hwang, Tae Gun Shin, Tae Rim Lee, Won Chul Cha, Min Seob Sim, Ik Joon Jo, Keun Jeong Song, Joong Eui Rhee, Yeon Kwon Jeong
  Clinical and Experimental Emergency Medicine.2016; 3(2): 109.     CrossRef
• Combination could be another tool for bowel preparation?
  Jae Seung Soh, Kyung-Jo Kim
  World Journal of Gastroenterology.2016; 22(10): 2915.     CrossRef
• A randomized trial to compare the efficacy and tolerability of sodium picosulfate-magnesium citrate solution vs. 4 L polyethylene glycol solution as a bowel preparation for colonoscopy
  Miguel Muñoz-Navas, José Luis Calleja, Guillermo Payeras, Antonio José Hervás, Luis Esteban Abreu, Víctor Orive, Pedro L. Menchén, José María Bordas, José Ramón Armengol, Cristina Carretero, Vicente Pons Beltrán, Inmaculada Alonso-Abreu, Román Manteca, Ad
  International Journal of Colorectal Disease.2015; 30(10): 1407.     CrossRef
• Sodium picosulfate/magnesium citrate/ hydrochlorothiazide
  
  Reactions Weekly.2015; 1549(1): 223.     CrossRef