Khositseth Sookkasem, Intrakao Sugravan, Pao-in Wanida, Visudtibhan Ananit
Department of Pediatrics, Faculty of Medicine, Thammasat University, Pathumthani, Thailand.
J Med Assoc Thai. 2010 Dec;93 Suppl 7:S299-302.
Osmotic demyelination syndrome (ODS) is an uncommon acute demyelinating process which involves the central nervous system. Rapid correction of chronic hyponatremia with increasing serum osmolality is the most common cause of ODS. We report the first case of an infant with moderate dehydration and initially normal serum Na who developed ODS associated with a fluctuation of serum osmolality. We present the lowest decreasing rate of serum Na level ever reported causing ODS. The fluctuation of serum osmolality in this case expands the list of precipitating causes of ODS in children. The case also highlights the appropriate intravenous fluid for initial rehydration in infant.
渗透性脱髓鞘综合征（ODS）是一种累及中枢神经系统的罕见急性脱髓鞘过程。慢性低钠血症伴血清渗透压快速纠正，是ODS最常见的病因。我们报告了首例患有中度脱水且最初血清钠正常的婴儿，该婴儿发生了与血清渗透压波动相关的ODS。我们呈现了导致ODS报道中血清钠水平最低的下降速率。该病例中血清渗透压的波动扩展了儿童ODS诱发原因的范围。该病例还突出了婴儿初始补液时合适的静脉输液。
