title: Radiologic predictors of hyponatremia in children hospitalized with community-acquired pneumonia.
abstract: BACKGROUND
  Hyponatremia (HNa) is the most common electrolyte imbalance seen in clinical practice and a common laboratory finding in children with community-acquired pneumonia (CAP). This study investigated whether there is a link between the radiological pattern seen in patients with CAP and the occurrence of HNa, hypothesizing that children with moderate and severe HNa would have a lobar-segmental pattern on chest radiograph.
  
  
  METHODS
  The medical files and chest radiographs of 54 children with moderate to severe HNa (sodium <130 mmol/L) admitted with CAP over a 2-year period at our institution were retrospectively studied. Community-acquired pneumonia was defined as either lobar-segmental or interstitial by a radiologist blinded to laboratory results.
  
  
  RESULTS
  Hyponatremia was seen more frequently in children with lobar-segmental pneumonia: 40 (74%) compared with 14 (26%) with interstitial pneumonia (P = 0.004). There was no relationship between the pattern of pneumonia seen on chest radiograph and severity of HNa; however, all 6 cases of severe HNa had lobar-segmental CAP, and all patients with complicated CAP were from the lobar-segmental group.
  
  
  CONCLUSIONS
  We found an association between lobar-segmental CAP and moderate or severe HNa. In addition, all cases of severe HNa occurred in patients with lobar-segmental CAP. The presence of a lobar-segmental pattern on chest radiography in CAP suggests the need for assessment of electrolyte status even in patients with adequate respiratory status.
authors.affiliation: Division of Pediatric Emergency Medicine, Department of Pediatrics, Dana Children's Hospital, Tel Aviv, Israel. Nopasara73@hotmail.com
authors.forename: Miguel
authors.initials: M
authors.lastname: Glatstein
authors.forename: Roni
authors.initials: R
authors.lastname: Rozen
authors.forename: Dennis
authors.initials: D
authors.lastname: Scolnik
authors.forename: Ayelet
authors.initials: A
authors.lastname: Rimon
authors.forename: Galia
authors.initials: G
authors.lastname: Grisaru-Soen
authors.forename: Stephen
authors.initials: S
authors.lastname: Freedman
authors.forename: Shimon
authors.initials: S
authors.lastname: Reif
mesh_terms: D017714:Community-Acquired Infections / Q000453:epidemiology; D005260:Female; D006760:Hospitalization; D006801:Humans; D007010:Hyponatremia / Q000453:epidemiology*; D008168:Lung / Q000000981:diagnostic imaging*; D017563:Lung Diseases, Interstitial / Q000000981:diagnostic imaging; D008297:Male; D011014:Pneumonia / Q000000981:diagnostic imaging*; D011859:Radiography; D012189:Retrospective Studies; D012720:Severity of Illness Index