Department of Neurology, University Hospital of Heidelberg, Heidelberg, Germany.
J Neurol Neurosurg Psychiatry. 2011 Sep;82(9):1051-3. doi: 10.1136/jnnp.2009.192369. Epub 2010 Aug 22.
Cerebral salt-wasting syndrome and the syndrome of inappropriate antidiuresis (SIAD) are the most important causes of non-iatrogenic hyponatraemia that can significantly complicate various brain diseases. Salt wasting without an underlying CNS disease may have been disregarded so far by clinicians and has been described as renal salt-wasting (RSW) in patients as drug side effect (eg, cisplatin), in older people with various common diseases (eg, hip fracture, pulmonary infections) and other sporadic conditions. In Guillain-Barré Syndrome (GBS), however, hyponatraemia has been described mainly as SIAD. However, symptoms of hyponatraemia rarely develop in GBS. Here, we report on a woman with GBS with dominant symptoms of dysautonomia and moderate severe hyponatraemia. We could identify RSW as part of the autonomic dysfunction that significantly contributed to disease worsening.
脑性盐耗综合征和抗利尿激素不适当分泌综合征（SIAD）是最重要的非医源性低钠血症病因，可显著使各种脑部疾病复杂化。目前，临床医生可能忽略了无潜在中枢神经系统疾病的盐耗，并且在患有各种常见疾病（如髋部骨折、肺部感染）和其他散发性疾病的患者中，将其描述为药物的副作用（如顺铂）所致的肾性盐耗（RSW）。然而，在吉兰-巴雷综合征（GBS）中，低钠血症主要被描述为 SIAD。然而，GBS 中很少出现低钠血症的症状。在这里，我们报告了一例以自主神经功能障碍为主且伴有中度严重低钠血症的 GBS 女性患者。我们可以将 RSW 确定为自主神经功能障碍的一部分，这对疾病恶化有重要影响。
