title: Plasma arginine vasopressin and the syndrome of inappropriate antidiuretic hormone secretion in tuberculous meningitis.
abstract: Biochemical evidence of the syndrome of inappropriate antidiuretic hormone secretion (SIADH) was documented in 17 of 24 (71%) children with tuberculous meningitis. Plasma arginine vasopressin concentrations in patients with signs of SIADH were significantly higher (median, 15.44 (range, 1.62 to greater than 24.52) pg/ml; n = 14) than those without (median, 1.91 (range, 0.44 to 4.91) pg/ml; n = 6) (P less than 0.002). Patients who developed evidence of SIADH were older than those who did not (median, 34 (range, 6 to 101) months vs. 10 (range, 6 to 38) months; P less than 0.007). Five patients with and none without died. In 9 patients evidence of SIADH developed only after hospitalization. These patients received a median of 58 (range, 28 to 109) ml/kg/day fluids (n = 7) before developing evidence of SIADH compared with 107 (range, 58 to 146) ml/kg/day received by patients who did not develop SIADH (n = 6) (P = 0.035). SIADH occurs commonly and its presence appears to influence the outcome of tuberculous meningitis in children.
authors.affiliation: Department of Pediatrics and Child Health, University of Stellenbosch, Republic of South Africa.
authors.forename: M F
authors.initials: MF
authors.lastname: Cotton
authors.forename: P R
authors.initials: PR
authors.lastname: Donald
authors.forename: J F
authors.initials: JF
authors.lastname: Schoeman
authors.forename: C
authors.initials: C
authors.lastname: Aalbers
authors.forename: L E
authors.initials: LE
authors.lastname: Van Zyl
authors.forename: C
authors.initials: C
authors.lastname: Lombard
mesh_terms: D001127:Arginine Vasopressin / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007177:Inappropriate ADH Syndrome / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D007223:Infant; D008297:Male; D011446:Prospective Studies; D014390:Tuberculosis, Meningeal / Q000097:blood / Q000150:complications* / Q000175:diagnosis
chemical_list: D001127:Arginine Vasopressin