Professor’s Editorial Featured in the Annals of Internal Medicine

“A Little Hyponatremia”

Anne Sagalyn, M.D. ‘81, assistant clinical professor of Psychiatry and Behavioral Sciences in the GW School of Medicine and Health Sciences, had an article published in the Annals of Internal Medicine, titled “A Little Hyponatremia.” The article details Dr. Sagalyn’s 40-year struggle to find out what led to her mother’s death after, what should have been, a routine gallbladder surgery. Dr. Sagalyn was 12 years old when her mother passed away, and at the time, she was told only that her mother had an allergic reaction to a drug called promathezine, which caused severe brain damage that led to her death. Because she still had a lot of unanswered questions, she decided to pursue a career in medicine.

A series of events eventually led to the answers Dr. Sagalyn had been seeking—a chat with the chief of medicine at the hospital where her mother died; two patients who presented with hyponatremia; and some research that allowed her to discover that her mother died as a result of post-operative hyponatremia, or an electrolyte disturbance in which the sodium concentration in the serum is lower than normal. She further discovered that pre-menstral women are at significantly greater risk of catastrophic neurological outcomes with hyponatremia, because estrogen impairs the NA/K-ATPase pump in the brain.  In 1963, the year of her mother’s death, the doctors had no way of knowing the source of her mother’s sudden deterioration and death following routine surgery, but thanks to research and medical advancement, doctors now know that young women are especially at-risk for hyponatremic encephalopathy. This knowledge will help prevent other kids from experiencing the same kind of loss that Dr. Sagalyn experienced as a young girl.

This editorial appeared in the “On Being a Doctor” section of the October 4, 2011 edition of the Annals of Internal Medicine.

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