Journal of Korean Endocrine Society 2002;17(5):698-704.
Published online October 1, 2002.
A Case of Cerebral Salt Wasting Syndrome associated with Tuberculous Meningitis.
Seung Hyuk Rho, Ji Yong Choi, Taek Man Nam, Hyeon Kyu Kim, Seong Jin Lee, In Kyung Jeong, Eun Gyung Hong, Cheol Soo Choi, Doo Man Kim, Jae Myung Yu, Sung Hee Ihm, Moon Gi Choi, Hyung Joon Yoo, Sung Woo Park, Hyoung Cheol Kim
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
Key Words: Cerebral salt wasting syndrome, Tuberculous meningitis, Hyponatremia


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