{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T17:17:18Z","timestamp":1773422238374,"version":"3.50.1"},"reference-count":25,"publisher":"American Academy of Pediatrics (AAP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1999,6,1]]},"abstract":"\n Background.<\/jats:title>\n Although water intoxication leading to brain damage is common in children, fatal child abuse by forced water intoxication is virtually unknown.<\/jats:p>\n <\/jats:sec>\n \n Methods.<\/jats:title>\n During the prosecution of the homicide of an abused child by forced water intoxication, we reviewed all similar cases in the United States where the perpetrators were found guilty of homicide. In 3 children punished by forced water intoxication who died, we evaluated: the types of child abuse, clinical presentation, electrolytes, blood gases, autopsy findings, and the fate of the perpetrators.<\/jats:p>\n <\/jats:sec>\n \n Findings.<\/jats:title>\n Three children were forced to drink copious amounts of water (over 6 L). All had seizures, emesis, and coma, presenting to hospitals with hypoxemia (Po2 = 44 \u00b1 8 mm Hg) and hyponatremia (plasma Na = 112 \u00b1 2 mmol\/L). Although all showed evidence of extensive physical abuse, the history of forced water intoxication was not revealed to medical personnel, thus none of the 3 children were treated for their hyponatremia. All 3 patients died and at autopsy had cerebral edema and aspiration pneumonia. The perpetrators of all three deaths by forced water intoxication were eventually tried and convicted.<\/jats:p>\n <\/jats:sec>\n \n Interpretation.<\/jats:title>\n Forced water intoxication is a new generally fatal syndrome of child abuse that occurs in children previously subjected to other types of physical abuse. Patients present with coma, hyponatraemia, and hypoxemia of unknown etiology. If health providers were made aware of the association, the hyponatremia is potentially treatable.<\/jats:p>\n <\/jats:sec>","DOI":"10.1542\/peds.103.6.1292","type":"journal-article","created":{"date-parts":[[2004,8,13]],"date-time":"2004-08-13T23:45:45Z","timestamp":1092440745000},"page":"1292-1295","source":"Crossref","is-referenced-by-count":44,"title":["Fatal Child Abuse by Forced Water Intoxication"],"prefix":"10.1542","volume":"103","author":[{"given":"Allen I.","family":"Arieff","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara A.","family":"Kronlund","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[1999,6,1]]},"reference":[{"key":"2021121002530220200_B1","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1111\/j.1445-2197.1988.tb06240.x","article-title":"Pathogenesis of postoperative hyponatremia following correction of scoliosis in children.","volume":"58","author":"Cowley","year":"1988","journal-title":"Aust N Z J Surg."},{"key":"2021121002530220200_B2","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1001\/archpedi.1991.02160090037018","article-title":"Oral water intoxication in infants.","volume":"145","author":"Keating","year":"1991","journal-title":"Am J Dis Child."},{"key":"2021121002530220200_B3","doi-asserted-by":"crossref","first-page":"1218","DOI":"10.1136\/bmj.304.6836.1218","article-title":"Hyponatraemia and death or permanent brain damage in healthy children.","volume":"304","author":"Arieff","year":"1992","journal-title":"Br Med J."},{"key":"2021121002530220200_B4","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1007\/BF01956738","article-title":"Clinical settings and vasopressin function in hyponatraemic children.","volume":"152","author":"Gerigk","year":"1993","journal-title":"Eur J Pediatr."},{"key":"2021121002530220200_B5","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1542\/peds.68.3.349","article-title":"Water intoxication in normal infants: role of antidiuretic hormone in pathogenesis.","volume":"68","author":"David","year":"1981","journal-title":"Pediatrics."},{"key":"2021121002530220200_B6","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/S0022-3476(67)80087-8","article-title":"Acute symptomatic hyponatremia.","volume":"71","author":"Varavithya","year":"1967","journal-title":"J Pediatr."},{"key":"2021121002530220200_B7","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1136\/adc.55.5.401","article-title":"Acute water intoxication as another unusual manifestation of child abuse.","volume":"55","author":"Mortimer","year":"1980","journal-title":"Arch Dis Child."},{"key":"2021121002530220200_B8","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1542\/peds.100.5.735","article-title":"Covert video recordings of life-threatening child abuse: lessons for child protection.","volume":"100","author":"Southall","year":"1997","journal-title":"Pediatrics."},{"key":"2021121002530220200_B9"},{"key":"2021121002530220200_B10"},{"key":"2021121002530220200_B11"},{"key":"2021121002530220200_B12","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1002\/ana.410040410","article-title":"Changes in brain weights during the span of human life: relation of brain weights to body heights and body weights.","volume":"4","author":"Dekaban","year":"1978","journal-title":"Ann Neurol."},{"key":"2021121002530220200_B13"},{"key":"2021121002530220200_B14","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1037\/h0079426","article-title":"Munchausen syndrome by proxy: diagnosis and prevalence.","volume":"63","author":"Schreier","year":"1993","journal-title":"Am J Orthopsychiatry."},{"key":"2021121002530220200_B15","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1192\/bjp.169.3.268","article-title":"Factitious illness by proxy. Munchausen syndrome by proxy.","volume":"169","author":"Bools","year":"1996","journal-title":"Br J Psychiatry."},{"key":"2021121002530220200_B16"},{"key":"2021121002530220200_B17","first-page":"371","article-title":"Distinguishing sudden infant death syndrome from child abuse fatalities.","volume":"69","author":"1993\u20131994 CoCAaN","year":"1997","journal-title":"Del Med J."},{"key":"2021121002530220200_B18","doi-asserted-by":"crossref","first-page":"1529","DOI":"10.1056\/NEJM198606123142401","article-title":"Hyponatremia, convulsions, respiratory arrest, and permanent brain damage after elective surgery in healthy women.","volume":"314","author":"Arieff","year":"1986","journal-title":"N Engl J Med."},{"key":"2021121002530220200_B19","doi-asserted-by":"crossref","first-page":"758","DOI":"10.1097\/00003246-199106000-00005","article-title":"Management of hyponatremic seizures in children with hypertonic saline: a safe and effective strategy.","volume":"19","author":"Sarnaik","year":"1991","journal-title":"Crit Care Med."},{"key":"2021121002530220200_B20","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1007\/BF00878379","article-title":"Hyponatremia. Pathophysiology and treatment, a pediatric perspective.","volume":"6","author":"Grushkin","year":"1992","journal-title":"Pediatr Nephrol."},{"key":"2021121002530220200_B21","first-page":"1277","article-title":"Plasma and cerebrospinal fluid measures of arginine vasopressin secretion in patients with bulimia nervosa and in healthy subjects.","volume":"74","author":"Demitrack","year":"1992","journal-title":"J Clin Endocrinol Metab."},{"key":"2021121002530220200_B22","doi-asserted-by":"crossref","first-page":"551","DOI":"10.7326\/0003-4819-79-4-551","article-title":"Syndrome of inappropriate secretion of antidiuretic hormone with exacerbated psychosis.","volume":"79","author":"Dubovsky","year":"1973","journal-title":"Ann Intern Med."},{"key":"2021121002530220200_B23","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1056\/NEJM198305123081902","article-title":"Abnormalities in plasma and cerebrospinal arginine vasopressin in patients with anorexia nervosa.","volume":"308","author":"Gold","year":"1983","journal-title":"N Engl J Med."},{"key":"2021121002530220200_B24","first-page":"235","article-title":"Compulsive water drinking.","volume":"28","author":"Barlow","year":"1959","journal-title":"Q J Med."},{"key":"2021121002530220200_B25","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1152\/jappl.1964.19.1.134","article-title":"Response of normal subjects to prolonged high fluid intake.","volume":"19","author":"Habener","year":"1964","journal-title":"J Appl Physiol."}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/103\/6\/1292\/844020\/1292.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/103\/6\/1292\/844020\/1292.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,10]],"date-time":"2021-12-10T09:19:34Z","timestamp":1639127974000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/103\/6\/1292\/62324\/Fatal-Child-Abuse-by-Forced-Water-Intoxication"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1999,6,1]]},"references-count":25,"journal-issue":{"issue":"6","published-online":{"date-parts":[[1999,6,1]]},"published-print":{"date-parts":[[1999,6,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.103.6.1292","relation":{},"ISSN":["1098-4275","0031-4005"],"issn-type":[{"value":"1098-4275","type":"electronic"},{"value":"0031-4005","type":"print"}],"subject":[],"published":{"date-parts":[[1999,6,1]]}}}