Tuberc Respir Dis.  2005 Sep;59(3):306-310.

A Case of Cerebral Salt Wasting Syndrome Associated with Tuberculous Meningitis

• Lee JY
• Lee ES
• Lee JH
• Lim EJ
• Kim HS
• Jang JS
• Kim HK
• Kim DM
• Park YB
• Lee JY
• Mo EK

Abstract

Hyponatremia which is due to excessive sodium loss in the urine and decrease in extracellular fluid volume following an acute or chronic central nervous system injury, has been conjunctively described as cerebral salt wasting syndrome (CSWS). This syndrome is often confused with dilutional hyponatremia due to inappropriate secretion of antidiuretic hormone. Accurate diagnosis and management are mandatory for improvement of the course of the disease. This report describes a case of a 31-year-old male patient with CSWS associated with tuberculous meningitis. The patient exhibited hyponatremia, polyuria, excessive natriuresis, volume depletion, and hypotension. He was diagnosed to manifest CSWS and was treated by administration of fluids, salt, and fludrocortisone. After the respective treatments, symptoms of polyuria and hypotension were gradually resolved and hyponatremia was corrected.

Keyword

Cerebral salt wasting syndrome; Tuberculous meningitis; Hyponatremia

MeSH Terms

Adult
Central Nervous System
Diagnosis
Extracellular Fluid
Fludrocortisone
Humans
Hyponatremia
Hypotension
Male
Natriuresis
Polyuria
Sodium
Tuberculosis, Meningeal*
Wasting Syndrome*
Fludrocortisone
Sodium