A Case of Cerebral Salt Wasting Syndrome Associated with Tuberculous Meningitis.

Lee, Ja Young; Lee, Eun Sil; Lee, Jae Hyong; Lim, Eun Ju; Kim, Hyoung Su; Jang, Ji Seon; Kim, Hyeon Kyu; Kim, Doo Man; Park, Yong Bum; Lee, Jae Young; Mo, Eun Kyung

doi:2005.59.3.306

Tuberc Respir Dis > Volume 59(3); 2005 > Article

Case Report

Tuberculosis and Respiratory Diseases 2005;59(3):306-310.
DOI: https://doi.org/10.4046/trd.2005.59.3.306 Published online September 1, 2005.

A Case of Cerebral Salt Wasting Syndrome Associated with Tuberculous Meningitis.

Ja Young Lee, Eun Sil Lee, Jae Hyong Lee, Eun Ju Lim, Hyoung Su Kim, Ji Seon Jang, Hyeon Kyu Kim, Doo Man Kim, Yong Bum Park, Jae Young Lee, Eun Kyung Mo

Departments of Internal Medicine, College of Medicine, Hallym University, Chuncheon, Korea. bfspark@medimail.co.kr

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.

Key Words: Cerebral salt wasting syndrome, Tuberculous meningitis, Hyponatremia