Cerebral Salt Wasting Syndrome: A Complication of Meningitis in Hydrocephalus with VP Shunt Cerebral Salt Wasting and Meningitis
Journal of Pediatric Nephrology,
Vol. 9 No. 3 (2021),
4 September 2021
Cerebral salt wasting syndrome (CSWS) is an important cause of persistent hyponatremia in children admitted to the intensive care unit. It needs to be promptly differentiated from the syndrome of inappropriate antidiuretic hormone (SIADH) secretion as a cause of hyponatremia in pediatric neurological patients. These two entities often have similar presenting symptoms however the treatment of both can be drastically different, which makes the distinction critical. We present a 6-month-old male child with hydrocephalus secondary to aqueductal stenosis, a blocked VP shunt, meningitis, and hyponatremia. A diagnosis of CSWS was considered and fludrocortisone was started. The patient improved gradually with a reduction in urine output and a gradual increase in serum sodium levels. A diagnosis of CSWS should be strongly considered in hyponatremic pediatric patients with significant natriuresis and suitable treatment should be initiated promptly to prevent long-term neurologic sequelae.
How to Cite
Lv M, Lv C, and Jiang ZW. A P1aneurysm and Diabetes Insipidus Caused by Traumatic Brain Injury. The Neuroradiology Journal 2010; 23, 724-729.https://doi.org/10.1177/197140091002300614
Kalpan Edward, Rheumatic fever. In Behrman RE (Ed), Nelson Textbook of Pediatrics, 17th EDN, Philadelphia WB Saunders Company. 2004, 874-879.
N Chaudhary, S Pathak, M M Gupta. “Cerebral Salt Wasting Syndrome following Head Injury in a Child Managed Successfully with Fludrocortisone”, Case Reports in Pediatrics 2016, Article ID693746,4 pages.
Peters JP, Welt LG, Sims EAH, Oriff J, and Needham J. A Salt Wasting Syndrome Associated with Cerebral Disease. Transactions of the Association of American Physicians 1950; 63:57-64.
Lee SMK, Lanaspa MA, Sanchez-Lozada LG, and Johnson RJ. Hyponatremia with Persistent Elevated Urinary Fractional Uric Acid Excretion: Evidence for Proximal Tubular Injury. Kidney and Blood Pressure Research 2016;41:535-544.
Esposito P, Piotti G, Bianzina S, Malul Y, and Dal Canton A. The Syndrome of Inappropriate Antidiuresis: Pathophysiology, Clinical Management and New Therapeutic Options. Nephron Clinical Practice 2011;119, c62-c73.
Oh JY, Shin JI. Syndrome of inappropriate antidiuretic hormone secretion and cerebral/renal salt wasting syndrome: similarities and differences. Front Pediatr 2014;2:146.
Yee AH, Burns JD, Wijdicks EF. Cerebral salt wasting: pathophysiology, diagnosis, and treatment. Neurosurg Clin N Am. 2010 Apr;21(2):339-52.
Oh JY, Shin JI. Syndrome of inappropriate antidiuretic hormone secretion and cerebral/renal salt wasting syndrome: similarities and differences. Front Pediatr. 2015;2:146.
Tuberculous Meningitis complicate with hydrocephalus and cerebral salt wasting syndrome in a three-year-old boy. Pediatr Infect Dis J. 2004;23: 884-886.
PB Nelson, SM Seif, JC Maroon, and A G Robinson. Hyponatremia in intracranial disease; perhaps not the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). Journal of Neurosurgery 1981;55(6):938-941.
Jabbar A, Farrukh S, Khan R. Cerebral salt wasting syndrome in tuberculous meningitis. Journal of the Pakistan Medical Association 2010;60(11), 964-5.
C E Taplin, C T Cowell, M Silink, and G R Ambler. Fludrocortisone therapy in cerebral salt wasting. Pediatrics 2006;118(6):e1904–e1908.
Rudolph A, and Gantioque R. Differentiating between SIADH and CSW Using Fractional Excretion of Uric Acid and Phosphate: A Narrative Review. Neuroscience and Medicine 2018;9:53-62.
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