Hyponatremia in central partial diabetes insipidus due to postoperative hypothalamic tumor
| Autor: | S. Nagata, Keijiro Yabuta, Hajime Arai, Osamu Arisaka, Madoka Arisaka |
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| Rok vydání: | 1995 |
| Předmět: |
Male
Vasopressin medicine.medical_specialty Urine Hypothalamic disease Central nervous system disease Postoperative Complications Internal medicine Medicine Humans Osmoreceptor business.industry Brain Neoplasms Metabolic disorder Osmolar Concentration General Medicine medicine.disease Arginine Vasopressin Endocrinology Child Preschool Pediatrics Perinatology and Child Health Diabetes insipidus Neurology (clinical) business Hyponatremia hormones hormone substitutes and hormone antagonists Diabetes Insipidus |
| Zdroj: | Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery. 11(12) |
| ISSN: | 0256-7040 |
| Popis: | We report the case of a 4-year-old boy with a postoperative hypothalamic tumor, who exhibited unusual water and electrolyte disturbance. This developed as a late manifestation during the course of central diabetes insipidus (DI), which started when the patient was 2 years old. Clinically, hyponatremia and DI appeared alternatlely within 1 day. The hyponatremia (lowest value Na+ 115 mmol/l) was associated with afebrile convulsions. Assessment of fluid status revealed that the patient had a reduced capacity for arginine vasopressin (AVP) secretion (partial DI), which was not physiologically regulated and which was not concomitantly sufficient to produce maximally concentrated urine and allow the production of maximally diluted urine. This defective osmoreceptor function in association with the previously existing reduced capacity for AVP release seemed to be responsible for the fluid disturbance in the patient. The administration of nasal 1-desamino-8d-arginine vasopressin (DDAVP) only when urine output was increased, instead of regular administration at a fixed time, prevented both worsening of hyponatremia and development of DI. |
| Databáze: | OpenAIRE |
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