지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2020.1
- 수록면
- 42 - 46 (5page)
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Disturbances in water and salt balances are relatively common in children after brain tumor surgery. However, the coexistence of different diseases of water and sodium homeostasis is challenging to diagnose and treat. The coexistence of combined central diabetes insipidus (CDI) and cerebral salt wasting syndrome (CSWS) is rare and may impede accurate diagnosis. Herein, we report the case of an 18-year-old girl who underwent surgery for a germinoma and who presented prolonged coexistence of CDI and CSWS. The patient was diagnosed with panhypopituitarism with CDI at presentation and was treated with hydrocortisone, levothyroxine, and desmopressin. Postoperatively, she developed polyuria of more than 3L/day, with a maximum daily urine output of 7.2 L/day. Her serum sodium level decreased from 148 to 131 mEq/L. Polyuria was treated with desmopressin at incremental doses, and hyponatremia was managed with fluid replacement. At 2 months after surgery, she presented with hyponatremia-induced seizure. Polyuria and hyponatremia combined with natriuresis indicated CSWS. Treatment with fludrocortisone were initiated; then, her electrolyte level gradually normalized. CSWS is self-limiting and generally resolves within 2 weeks. However, the patient in this study still required treatment with vasopressin and fludrocortisone at 16-months after surgery. Hyponatremia in a patient with CDI may be erroneously interpreted as inadequate CDI control or syndrome of inappropriate antidiuretic hormone secretion, leading to inappropriate treatment. The identification of the potential combination of CDI and CSWS is important for early diagnosis and treatment.
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참고문헌 (15)
참고문헌 신청
Edate S / 2015 / Management of electrolyte and fluid disorders after brain surgery for pituitary/suprasellar tumours / Horm Res Paediatr 83:293~301
John CA / 2012 / Central neurogenic diabetes insipidus, syndrome of inappropriate secretion of antidiuretic hormone, and cerebral salt-wasting syndrome in traumatic brain injury / Crit Care Nurse 32:e1~7
Kiran Z / 2017 / Sodium and water imbalance after sellar, suprasellar, and parasellar surgery / Endocr Pract 23:309~317
Sperling MA / 2014 / Pediatric Endocrinology / Elsevier
Ferry RJ, Jr / 2001 / Hyponatremia and polyuria in children with central diabetes insipidus:challenges in diagnosis and management / J Pediatr 138:744~747
John CA / 2012 / Central neurogenic diabetes insipidus, syndrome of inappropriate secretion of antidiuretic hormone, and cerebral salt-wasting syndrome in traumatic brain injury / Crit Care Nurse 32:e1~7
Kiran Z / 2017 / Sodium and water imbalance after sellar, suprasellar, and parasellar surgery / Endocr Pract 23:309~317
Sperling MA / 2014 / Pediatric Endocrinology / Elsevier
Ferry RJ, Jr / 2001 / Hyponatremia and polyuria in children with central diabetes insipidus:challenges in diagnosis and management / J Pediatr 138:744~747
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