Pediatric Hyponatremia Differential Diagnoses

  • Author: Muthukumar Vellaichamy, MD, FAAP; Chief Editor: Timothy E Corden, MD   more...
 
Updated: Jul 27, 2011
 
 
 
Contributor Information and Disclosures
Author

Muthukumar Vellaichamy, MD, FAAP  Clinical Assistant Professor, Department of Pediatrics, University of Kansas School of Medicine-Wichita, Wesley Medical Center

Muthukumar Vellaichamy, MD, FAAP is a member of the following medical societies: American Academy of Pediatrics and Society of Critical Care Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

G Patricia Cantwell, MD, FCCM  Professor of Clinical Pediatrics, University of Miami, Leonard M Miller School of Medicine; Chief, Division of Pediatric Critical Care Medicine, Medical Manager, Urban Search & Rescue, South Florida TF-2, Medical Director, Holtz Children's Hospital Palliative Care Team, Medical Director, Tilli Kids – Pediatric Initiative of Hospice Care of SE Florida, Director, Pediatric Critical Care Transport, Holtz Children's Hospital/Jackson Memorial Hospital

G Patricia Cantwell, MD, FCCM is a member of the following medical societies: American Academy of Hospice and Palliative Medicine, American Academy of Pediatrics, American Heart Association, American Trauma Society, National Association of EMS Physicians, Society of Critical Care Medicine, and Wilderness Medical Society

Disclosure: Nothing to disclose.

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Barry J Evans, MD  Assistant Professor of Pediatrics, Temple University Medical School; Director of Pediatric Critical Care and Pulmonology, Associate Chair for Pediatric Education, Temple University Children's Medical Center

Barry J Evans, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Chest Physicians, American Thoracic Society, and Society of Critical Care Medicine

Disclosure: Nothing to disclose.

Mary E Cataletto, MD  Director of Children's Sleep Services, Winthrop Sleep Disorders Center, Mineola, NY; Professor of Clinical Pediatrics, State University of New York at Stony Brook, Stony Brook, NY

Mary E Cataletto, MD is a member of the following medical societies: American Academy of Pediatrics and American College of Chest Physicians

Disclosure: Shering Plough Pharmaceuticals Honoraria Consulting

Chief Editor

Timothy E Corden, MD  Associate Professor of Pediatrics, Co-Director, Policy Core, Injury Research Center, Medical College of Wisconsin; Associate Director, PICU, Children's Hospital of Wisconsin

Timothy E Corden, MD is a member of the following medical societies: American Academy of Pediatrics, Phi Beta Kappa, Society of Critical Care Medicine, and Wisconsin Medical Society

Disclosure: Nothing to disclose.

Acknowledgments

The author would like to acknowledge his partner at work, mentor, and great physician Lindall Smith, MD, for reading the manuscript and offering valuable advice.

References
  1. Moritz ML, Ayus JC. The pathophysiology and treatment of hyponatraemic encephalopathy: an update. Nephrol Dial Transplant. Dec 2003;18(12):2486-91. [Medline].

  2. Ayus JC, Achinger SG, Arieff A. Brain cell volume regulation in hyponatremia: role of sex, age, vasopressin, and hypoxia. Am J Physiol Renal Physiol. Sep 2008;295(3):F619-24. [Medline].

  3. Prasad SV, Singhi S, Chugh KS. Hyponatremia in sick children seeking pediatric emergency care. Indian Pediatr. Mar 1994;31(3):287-94. [Medline].

  4. Au AK, Ray PE, McBryde KD, Newman KD, Weinstein SL, Bell MJ. Incidence of postoperative hyponatremia and complications in critically-ill children treated with hypotonic and normotonic solutions. J Pediatr. Jan 2008;152(1):33-8. [Medline].

  5. Mentes JC. Hydration management protocol. J Gerontol Nurs. Oct 2000;26(10):6-15. [Medline].

  6. Rey C, Los-Arcos M, Hernández A, Sánchez A, Díaz JJ, López-Herce J. Hypotonic versus isotonic maintenance fluids in critically ill children: a multicenter prospective randomized study. Acta Paediatr. Aug 2011;100(8):1138-43. [Medline].

  7. Wright DG, Laureno R, Victor M. Pontine and extrapontine myelinolysis. Brain. Jun 1979;102(2):361-85. [Medline].

  8. Sterns RH, Cappuccio JD, Silver SM, Cohen EP. Neurologic sequelae after treatment of severe hyponatremia: a multicenter perspective. J Am Soc Nephrol. Feb 1994;4(8):1522-30. [Medline].

  9. Carey RG, Bucuvalas JC, Balistreri WF, Nick TG, Ryckman FR, Yazigi N. Hyponatremia increases mortality in pediatric patients listed for liver transplantation. Pediatr Transplant. Feb 20 2009;[Medline].

  10. Adrogue HJ, Madias NE. Hyponatremia. N Engl J Med. May 25 2000;342(21):1581-9. [Medline].

  11. Anderson RJ. Hospital-associated hyponatremia. Kidney Int. Jun 1986;29(6):1237-47. [Medline].

  12. Ayus JC, Arieff AI. Pulmonary complications of hyponatremic encephalopathy. Noncardiogenic pulmonary edema and hypercapnic respiratory failure. Chest. Feb 1995;107(2):517-21. [Medline].

  13. Ayus JC, Armstrong D, Arieff AI. Hyponatremia with hypoxia: effects on brain adaptation, perfusion, and histology in rodents. Kidney Int. Apr 2006;69(8):1319-25. [Medline].

  14. Berry PL, Belsha CW. Hyponatremia. Pediatr Clin North Am. Apr 1990;37(2):351-63. [Medline].

  15. Brown WD. Osmotic demyelination disorders: central pontine and extrapontine myelinolysis. Curr Opin Neurol. Dec 2000;13(6):691-7. [Medline].

  16. Ellison DH, Berl T. Clinical practice. The syndrome of inappropriate antidiuresis. N Engl J Med. May 17 2007;356(20):2064-72. [Medline].

  17. Fraser CL, Arieff AI. Epidemiology, pathophysiology, and management of hyponatremic encephalopathy. Am J Med. Jan 1997;102(1):67-77. [Medline].

  18. Gross P. Treatment of severe hyponatremia. Kidney Int. Dec 2001;60(6):2417-27. [Medline].

  19. Gruskin AB, Sarnaik A. Hyponatremia: pathophysiology and treatment, a pediatric perspective. Pediatr Nephrol. May 1992;6(3):280-6. [Medline].

  20. Harrigan MR. Cerebral salt wasting syndrome. Crit Care Clin. Jan 2001;17(1):125-38. [Medline].

  21. Haycock GB. The syndrome of inappropriate secretion of antidiuretic hormone. Pediatr Nephrol. Jun 1995;9(3):375-81. [Medline].

  22. Kappy MS, Ganong CA. Cerebral salt wasting in children: the role of atrial natriuretic hormone. Adv Pediatr. 1996;43:271-308. [Medline].

  23. Kennedy PG, Mitchell DM, Hoffbrand BI. Severe hyponatraemia in hospital inpatients. Br Med J. Nov 4 1978;2(6147):1251-3. [Medline]. [Full Text].

  24. Lin M, Liu SJ, Lim IT. Disorders of water imbalance. Emerg Med Clin North Am. Aug 2005;23(3):749-70, ix. [Medline].

  25. Marino PL. Hypertonic and hypotonic syndromes. In: The ICU Book. 2nd ed. Philadelphia, Pa: Lippincott Williams and Wilkins; 1998:631-46.

  26. Martin RJ. Central pontine and extrapontine myelinolysis: the osmotic demyelination syndromes. J Neurol Neurosurg Psychiatry. Sep 2004;75 Suppl 3:iii22-8. [Medline].

  27. Moritz ML, Ayus JC. Disorders of water metabolism in children: hyponatremia and hypernatremia. Pediatr Rev. Nov 2002;23(11):371-80. [Medline].

  28. Musana AK, Yale SH. Central pontine myelinolysis: case series and review. WMJ. Aug 2005;104(6):56-60. [Medline].

  29. Oh MS, Kim HJ, Carroll HJ. Recommendations for treatment of symptomatic hyponatremia. Nephron. 1995;70(2):143-50. [Medline].

  30. Sterns RH. The treatment of hyponatremia: first, do no harm. Am J Med. Jun 1990;88(6):557-60. [Medline].

  31. Sterns RH, Silver SM. Brain volume regulation in response to hypo-osmolality and its correction. Am J Med. Jul 2006;119(7 Suppl 1):S12-6. [Medline].

  32. Verbalis JG, Goldsmith SR, Greenberg A, Schrier RW, Sterns RH. Hyponatremia treatment guidelines 2007: expert panel recommendations. Am J Med. Nov 2007;120(11 Suppl 1):S1-21. [Medline].

  33. Yeates KE, Singer M, Morton AR. Salt and water: a simple approach to hyponatremia. CMAJ. Feb 3 2004;170(3):365-9. [Medline].

  34. Zarinetchi F, Berl T. Evaluation and management of severe hyponatremia. Adv Intern Med. 1996;41:251-83. [Medline].

Previous
Next
 
Drugs that impair water excretion.
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.