Hyponatremia in pediatric patients with HIV-1 infection.
Hyponatremia has been recognized as a complication in adults with acquired immunodeficiency syndrome (AIDS). We did a retrospective study evaluating the medical records of 86 children (age 4 months to 21 years) with human immunodeficiency virus (HIV-1) infection to determine the frequency and clinical associations of hyponatremia. Twenty-two children (26%) developed hyponatremia (serum sodium < 135 mEq/L; range 104 to 134 mEq/L; mean 130 mEq/L). Fourteen were male; 18 of the 22 patients were black and 4 were white. At the time of hyponatremia, the children frequently had comorbid associations, including 8 (35%) with AIDS encephalopathy; 3 (14%) with cardiomyopathy; 3 (14%) using diuretics; 1 (5%) using pentamidine; 3 (14%) with bacterial pneumonia; 2 (9%) requiring gastric lavage feedings; 2 (9%) with tuberculosis meningitis; 2 (9%) with gastroenteritis; 1 (5%) with infection caused by Mycobacterium avium-intracellulare; 1 (5%) each with brain tumor and tumor metastasis to brain. The cause of hyponatremia was attributed to syndrome of inappropriate antidiuretic hormone in 8 children; poor sodium intake and/or excessive diarrheal losses in 5; and the use of diuretics in 3 patients. Mild hyponatremia with no identifiable cause was found in 5 patients.
D015526:AIDS Dementia Complex / Q000453:epidemiology; D000386:AIDS-Related Complex / Q000150:complications* / Q000276:immunology; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000276:immunology; D000293:Adolescent; D000328:Adult; D001932:Brain Neoplasms / Q000453:epidemiology; D018791:CD4 Lymphocyte Count; D009202:Cardiomyopathies / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology; D015497:HIV-1; D006801:Humans; D007010:Hyponatremia / Q000453:epidemiology* / Q000209:etiology; D015994:Incidence; D007223:Infant; D002542:Intracranial Embolism and Thrombosis / Q000453:epidemiology; D008297:Male; D011014:Pneumonia / Q000453:epidemiology; D012189:Retrospective Studies; D014390:Tuberculosis, Meningeal / Q000453:epidemiology