Fludrocortisone treatment in a child with severe cerebral salt wasting.

Abstract:

:Hyponatremia is a common complication of intracranial disease or surgery. An evaluation should be undertaken to determine whether cerebral salt wasting (CSW) or inappropriate secretion of antidiuretic hormone is present as a cause. Since the treatment principles are completely different in the two pathological states, differential diagnosis is very important. CSW is defined as the renal loss of sodium leading to hyponatremia and decreased extracellular fluid volume. In the literature, it has been noted that mineralocorticoid administration can be useful in CSW cases. We herein present an 11-year-old boy who developed hyponatremic seizures after intracranial tumor resection. He was diagnosed with CSW on the basis of high urinary sodium excretion and increased urine output, together with signs and symptoms of dehydration. Despite intensive fluid and salt therapy, we were unable to decrease the urinary output. Therefore, fludrocortisone therapy was administered and his urinary output and sodium excretion were decreased and his serum sodium level was normalized. In conclusion, in addition to fluid and salt replacement, mineralocorticoid supplementation also seems to be a safe and effective treatment for CSW.

journal_name

Pediatr Neurosurg

journal_title

Pediatric neurosurgery

authors

Kinik ST,Kandemir N,Baykan A,Akalan N,Yordam N

doi

10.1159/000050424

keywords:

subject

Has Abstract

pub_date

2001-10-01 00:00:00

pages

216-9

issue

4

eissn

1016-2291

issn

1423-0305

pii

50424

journal_volume

35

pub_type

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