J Korean Soc Endocrinol.  2002 Oct;17(5):698-704.

A Case of Cerebral Salt Wasting Syndrome associated with Tuberculous Meningitis

Affiliations
  • 1Department of Internal Medicine, College of Medicine, Hallym University, Chuncheon, Korea. hkkim@hallym.or.kr
  • 2Department of Neurology, College of Medicine, Hallym University, Chuncheon, Korea.

Abstract

Hyponatremia in patients with central nervous system disorders is suggestive of the syndrome of inappropriate secretion of antidiuretic hormone (SIADH), and volume restriction is recommended for its correction. However, if volume depletion is present in a situation otherwise compatible with SIADH, cerebral salt wasting syndrome (CSWS) should be considered as the cause of the hyponatremia to avoid hypovolemic shock that may be induced by the standard management of SIADH, i.e. volume restriction. We present a case of a 17-year-old male patient with CSWS associated with tuberculous meningitis. The clinical feature of the patient comprised hyponatremia, excessive natriuresis, polyuria, and hypovolemia. Following the administration of saline and fludrocortisone, natriuresis and polyuria were decreased, and the hyponatremia improved


MeSH Terms

Adolescent
Central Nervous System Diseases
Fludrocortisone
Humans
Hyponatremia
Hypovolemia
Inappropriate ADH Syndrome
Male
Natriuresis
Polyuria
Shock
Tuberculosis, Meningeal*
Wasting Syndrome*
Fludrocortisone
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