title: Treatment of Severe Hypervolemic Hyponatremia in a Child With Pneumonia.
abstract: A 21-month-old boy came to our attention because of pneumonia. His weight increased before presentation, and his blood test results showed hyponatremia (116 mEq/L), low plasma osmolarity (241 mOsm/L), and high urine osmolarity (435 mOsm/L). He was treated with 0.9% sodium chloride solution and intravenous furosemide, and sodium levels rose up to 135 mEq/L in 36 hours. No standard treatment is available for severe hyponatremia in children. The use of vaptans in pediatric patients is described in literature, but it lacks evidence about safety and effectiveness. We suggest that furosemide administration plus salt replacement is effective in restoring normal values of plasma sodium concentration in severe euvolemic and hypervolemic hyponatremia.
authors.affiliation: From the Departments of *Pediatric Emergency, †Pathophysiology and Transplantation, and ‡Pediatric Surgery, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: Teresa
authors.initials: T
authors.lastname: Genoni
authors.forename: Rossana
authors.initials: R
authors.lastname: Tenconi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Bertolozzi
authors.forename: Emanuela Anna
authors.initials: EA
authors.lastname: Laicini
authors.forename: Giacomo
authors.initials: G
authors.lastname: Tardini
authors.forename: Federica
authors.initials: F
authors.lastname: Vianello
authors.forename: Ernesto
authors.initials: E
authors.lastname: Leva
authors.forename: Gregorio Paolo
authors.initials: GP
authors.lastname: Milani
authors.forename: Emilio Filippo
authors.initials: EF
authors.lastname: Fossali
mesh_terms: D003937:Diagnosis, Differential; D004232:Diuretics / Q000627:therapeutic use; D005440:Fluid Therapy; D005665:Furosemide / Q000627:therapeutic use; D006801:Humans; D007010:Hyponatremia / Q000175:diagnosis* / Q000628:therapy; D007177:Inappropriate ADH Syndrome / Q000175:diagnosis* / Q000628:therapy; D007223:Infant; D008297:Male; D011014:Pneumonia / Q000175:diagnosis* / Q000628:therapy
chemical_list: D004232:Diuretics; D005665:Furosemide