Severe symptomatic hyponatremia due to cerebral salt wasting syndrome in a patient with traumatic head injury and Dandy-Walker malformation of the brain.

Clinical Nephrology. Case Studies Pub Date : 2021-02-19 eCollection Date: 2021-01-01 DOI:10.5414/CNCS110146
Orfeas Liangos, Nicolaos E Madias
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引用次数: 1

Abstract

Cerebral salt wasting (CSW) is an uncommon cause of hyponatremia characterized by extracellular volume depletion, high urine sodium concentration and osmolality, and low serum uric acid concentration in association with central nervous system (CNS) disease. Distinguishing CSW from the syndrome of inappropriate secretion of antidiuretic hormone (SIADH), a much more common form of hyponatremia in this setting, can be challenging because both present with identical laboratory features. However, treatment of CSW and SIADH differs, making a correct diagnosis important. Here we present a case of CSW in a 75-year-old man in whom severe hyponatremia and volume depletion were discovered in the setting of traumatic head injury and Dandy-Walker malformation of the brain, a rare congenital brain malformation. Treatment with intravenous normal saline and later oral salt supplementation and fludrocortisone was successful.

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外伤性脑损伤伴Dandy-Walker脑畸形患者脑盐消耗综合征所致严重症状性低钠血症1例。
脑盐消耗(CSW)是一种罕见的低钠血症的病因,其特征是与中枢神经系统(CNS)疾病相关的细胞外容量减少、高尿钠浓度和高渗透压以及低血清尿酸浓度。区分CSW和抗利尿激素分泌不当综合征(SIADH)是低钠血症的一种更常见的形式,可能具有挑战性,因为两者具有相同的实验室特征。然而,CSW和SIADH的治疗方法不同,因此正确诊断很重要。我们在此报告一位75岁的男性CSW病例,他在创伤性头部损伤和脑Dandy-Walker畸形(一种罕见的先天性脑畸形)的背景下发现了严重的低钠血症和容量耗损。静脉注射生理盐水,后来口服盐补充和氟化可的松治疗成功。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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