Cerebral salt wasting syndrome: Review

Cerdà-Esteve, Mariaina; Cuadrado-Godia, Elisa; Chillarón, Josep; Pont‐Sunyer, Claustre; Cucurella, Gràcia; Fernández, Marcos; Goday, Albert; Cano-Pérez, Juan F.; Rodríguez-Campello, Ana; Roquer, Jaume

doi:10.1016/j.ejim.2007.06.019

Cited by 100 publications

(111 citation statements)

References 44 publications

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“…Similarly, the clinical setting of dilutional hyponatremia in this case suggested the possible existence of psychotic polydipsia. CSWS is a hyponatremia caused by renal sodium wasting, and is commonly associated with intracranial diseases, such as cerebral hemorrhage or infarction, which is known to be closely related to the overproduction of ANP or BNP [3]. In the present case, the demonstrated high value of urine sodium concentration did not mean over-excretion of urine sodium, but indicates concentrated urine because of impaired free water excretion shown by the negative value of free water clearance (-3009 mL/day) and non-elevated sodium excretion ratio (FENa; 1.46 % on admission).…”

Section: Discussionmentioning

confidence: 99%

A case of the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) associated with lupus erythematosus in the central nervous system

et al. 2012

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We report on a case of the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) associated with lupus erythematosus in the central nervous system (CNS). A 73-year-old woman with essential hypertension suddenly demonstrated consciousness disturbance. Upon her admission, laboratory data showed significant hyponatremia (114 mEq/L) and a lack of body fluid loss. Diminished free water excretion (urine osmolality 684 mOsm/kg) and normal urine Na excretion (FENa 1.70 %) were consistent with the diagnosis of SIADH, which was confirmed by an inappropriately high concentration of plasma antidiuretic hormone (ADH) (15.3 pg/mL at 256 mOsm/kg of plasma osmolality). The hyponatremia was corrected by a combination of oral water intake restriction and saline infusion with furosemide administration until the 20th hospital day. Simultaneously, the presence of exudative pleural effusion in both chest cavities, suggesting the existence of pleuritis, and high titer of anti-nuclear antibody (ANA, 51209) and anti-doublestrand DNA antibody (6500 IU/mL), indicated the subclinical development of systemic lupus erythematosus (SLE), although the diagnostic criteria were not satisfied at that time. On the 34th hospital day, the sudden onset of unknown consciousness disturbance confirmed the diagnosis of SLE as CNS lupus. In previous case reports on SLE and/or SIADH, a few cases in which SLE and SIADH developed concomitantly regularly showed high immunological activities, as in our case. Some common pathophysiological bases might be involved in the concomitant appearance of those disorders.

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Section: Discussionmentioning

confidence: 99%

A case of the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) associated with lupus erythematosus in the central nervous system

et al. 2012

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“…13 Mekanisme lainnya adalah cerebral salt wasting (CSW), hiponatremia translokasional, dan sick cell syndrome. 8,17,18 Risiko terjadinya hiponatremia pasca-operasi serta potensi bahaya yang ditimbulkan belum banyak disadari oleh para dokter yang bekerja di ruang perawatan intensif sehingga peneliti merasa bahwa penelitian mengenai hiponatremia pada pasien anak pasca-operasi perlu dilakukan.…”

Section: Hiponatremia Pada Anak Pasca Tindakan Operasi : Etiologi Danunclassified

Hiponatremia pada Anak Pasca Tindakan Operasi : Etiologi dan Faktor-faktor yang Berhubungan

Arifin¹,

Pudjiadi²,

Handryastuti³

et al. 2017

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Latar belakang. Kejadian hiponatremia pada anak pasca-operasi berkisar antara 20-40%. Hiponatremia yang tidak terdeteksi dapat meningkatkan mortalitas dan menyebabkan luaran neurologis yang buruk. Beberapa mekanisme yang berperan adalah sindrom hormon antidiuretik tidak tepat (SHATT) dan sick cell syndrome (SCS). Tujuan. Mengetahui insidens hiponatremia pada anak pasca-operasi, kemungkinan penyebab yang melatarbelakangi, serta faktor yang berhubungan. Metode. Penelitian potong lintang analitik dilakukan di ruang perawatan intensif terhadap anak berusia 1 bulan sampai 18 tahun yang menjalani tindakan operasi mayor dan masuk ruang perawatan intensif pediatrik RSCM selama bulan Mei sampai Desember 2016. Hasil. Terdapat 65 subyek menjalani operasi mayor, 87,69% dilakukan secara elektif, jenis operasi terbanyak adalah hepatogastrointestinal (38,46%) dan muskuloskeletal (20,00%). Kadar natrium plasma pasca-operasi turun, kejadian hiponatremia 43,07% dan 26,16% pada 12 dan 24 jam pasca-operasi. Nilai osmolalitas plasma yang normal atau meningkat dan osmolalitas urin >100 mOsm/kg. Sebanyak 70% subyek hiponatremia memiliki natrium urin >30 mEq/L. Faktor yang berhubungan dengan hiponatremia 12 jam pasca-operasi adalah status kegawatdaruratan operasi (p=0,007) dan perdarahan intraoperatif (p=0,024), sedangkan pada 24 jam pasca-operasi hanya status kegawatdaruratan operasi (p=0,001). Kesimpulan. Terdapat 43,07% dan 26,16% subyek yang mengalami hiponatremia pada 12 dan 24 jam pasca-operasi mayor. Sindrom hormon antidiuretik tidak tepat tidak terbukti menjadi penyebab utama terjadinya hiponatremia, dan hiponatremia translokasional pada SCS mungkin berperan. Hiponatremia pasca-operasi berhubungan dengan status kegawatdaruratan operasi dan jumlah perdarahan intraoperatif. Sari Pediatri 2017;19(2):63-70Kata kunci: hiponatremia, pasca-operasi, hormon antidiuretik, sick cell sydrome Hyponatremia in Post-surgery Pediatric Patients: Etiology and Its Related FactorsAngelina, Antonius H. Pudjiadi, Setyo Handryastuti, Idham Amir, Evita B. Ifran, Mulya R. KaryantiBackground. The incidence of hyponatremia in post-surgery pediatric patients is 20-40%. Undetected hyponatremia correlates with higher mortality and poor neurology outcomes. There are several mechanisms in post-surgery hyponatremia, such as syndrome of inappropriate antidiuretic hormone and sick cell syndrome. Objective. To establish the incidence of hyponatremia among post-surgery pediatric patients, possible etiologies, and its related factors. Method. Observational analytic study was conducted forchildren aged 1 month until 18 years old after underwent major surgery in CM hospital pediatric intensive care unit, between May and December 2016. Results. There were 65 subjects underwent mayor surgery, mostly (87.69%) were elective surgery. The most common surgeries were hepato-gastrointestinal (38,46%) and musculoskeletal (20,00%) surgery. There was significant reductionof plasma natrium after surgery, with hyponatremia incidence at 12 and 24 hours post-surgery were 43.07% and 2...

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“…Rapid correction of hyponatremia can cause central myelinolysis and should be avoided, but insuicient correction of hyponatremia can result in brain edema, convulsion, and death [17,[20][21][22].…”

Section: Treatment Of Hyponatremiamentioning

confidence: 99%

Aneurysmal subarachnoid hemorrhage

Chiriac

Poeată²,

Baldauf³

et al. 2013

Nursing

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Aneurysmal subarachnoid hemorrhage (SAH) is a devastating neurological syndrome, which occurs at a rate of 3-25 per 100,000 population. Smoking and hypertension are the most important risk factors of subarachnoid hemorrhage. Rupture of cerebral aneurysm leads to rapid spread of blood into cerebrospinal luid and subsequently leads to sudden increase of intracranial pressure and severe headache. Subarachnoid hemorrhage is associated with neurological (such as re-bleeding and vasospasm) and systemic (such as myocardial injury and hyponatremia) complications that are causes of high mortality and morbidity. Although patients with poor-grade subarachnoid hemorrhage are at higher risk of neurological and systemic complications, the early and aggressive management of this group of patient has decreased overall mortality by 17% in last 40 years. Early aneurysm repair, close monitoring in dedicated neurological intensive care unit, prevention, and aggressive management of medical and neurological complications are the most important strategies to improve outcome.

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Cerebral salt wasting syndrome: Review

Cited by 100 publications

References 44 publications

A case of the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) associated with lupus erythematosus in the central nervous system

A case of the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) associated with lupus erythematosus in the central nervous system

Hiponatremia pada Anak Pasca Tindakan Operasi : Etiologi dan Faktor-faktor yang Berhubungan

Aneurysmal subarachnoid hemorrhage

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