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KMID : 0391520130210030143
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Journal of the Korean Child Neurology Society
2013 Volume.21 No. 3 p.143 ~ p.151
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Hyponatremia in Children with Central Nervous System Infections
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Kim Su-Gon
Nam Sang-Ook
Kim Young-Mi
Yeon Gyu-Min
Lee Yun-Jin
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Abstract
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Purpose: To compare the effect of different etiologies in children with central nervous system (CNS) infections on the incidence of initial and hospital-acquired hyponatremia (IH and HAH) (plasma sodium concentration, PNa <135 mEq/L).
Methods: Children with CNS infections during the period between 2011 and 2012 were evaluated retrospectively. Patients were classified into 4 groups: group A, aseptic meningitis; group B, viral meningoencephalitis; group C, bacterial meningitis; group D, tuberculous meningitis. All patients had measured the initial PNa and were retested serially. By the sodium concentration of IV fluid, children were divided into 2 groups: group-I of <0.45% saline in dextrose, and group-II of > or =0.45% saline in dextrose.
Results: Of 244 children with CNS infections (group A: 185, group B: 33, group C: 23, and group D: 3), 55 patients (22.5%) revealed IH- or HAH-hyponatremia. IH and HAH was found in 13.1% (32/244) and 9.4% (23/244), respectively. The incidence of IH was significantly higher in group-C (30.4%, P=0.010) than in group-A (9.2%) or group-B (21.2%). HAH was more frequent in group-B (27.3%, P<0.001) and in group-D (66.7%, P=0.001) than in group-A (4.9%) or in group-C (13.0%). Of the patients in group-I, 28.6% (8/28) developed more common HAH compared with 6.9% (15/216) of children in group-II (P<0.001).
Conclusion: IH and HAH were relatively common in children with CNS infections and their incidences were distinctly different among patients from different etiologies. It seems that the administration of hypertonic saline can help to reduce the incidence of HAH among children with CNS infections. election.
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KEYWORD
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Hyponatremia, Central nervous system infections, Meningitis, Child
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