title: Cerebral salt wasting in tuberculous meningitis: Two cases and review of the literature. Case Report.
abstract: Cerebral salt wasting syndrome (CSWS) is characterized by severe natriuresis and volume depletion in the presence of cerebral pathology. In literature, there are few reports about tuberculous meningitis and cerebral CSWS. In this article, we report two tuberculous meningitis cases with CSWS and present a review of the literature on this topic. Cerebral salt wasting diagnosis was based on hyponatraemia associated with high urinary sodium excretion and inappropriately high urine output in the presence of dehydration. Treatment was made with sodium-fluid replacement plus fludrocortisone therapy in both cases. In agreement with the literature we argue that cerebral salt wasting syndrome might be more common than the syndromes of inappropriate antidiuretic hormone secretion (SIADH) in cerebral disorders. Differentiating the cerebral salt wasting syndrome from the SIADH is very important because unrecognized cerebral salt wasting syndrome can lead to inadequate management and result in unnecessary hyponatremia-related morbidity. The electrolyte and hydration status of patients should be monitored closely in patients with tuberculous meningitis.
authors.affiliation: Pediatric Infection, Adana Numune Research and Training Hospital, Turkey.
authors.forename: Umit
authors.initials: U
authors.lastname: Celik
authors.affiliation: Pediatric Neurology, Adana Numune Research and Training Hospital, Turkey.
authors.forename: Tamer
authors.initials: T
authors.lastname: Celik
authors.affiliation: Department of Pediatrics, Adana Numune Research and Training Hospital, Turkey.
authors.forename: Orkun
authors.initials: O
authors.lastname: Tolunay
authors.affiliation: Department of Pediatrics, Adana Numune Research and Training Hospital, Turkey.
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Başpınar
authors.affiliation: Pediatric Neurology, Adana Numune Research and Training Hospital, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Kömür
authors.affiliation: Department of Pediatrics, Texas Tech Health Sciences Center, USA.
authors.forename: Fatma
authors.initials: F
authors.lastname: Levent
mesh_terms: D000293:Adolescent; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007010:Hyponatremia / Q000188:drug therapy / Q000209:etiology*; D008297:Male; D012964:Sodium / Q000097:blood / Q000652:urine; D014390:Tuberculosis, Meningeal / Q000150:complications*
chemical_list: D012964:Sodium