Breinbjerg Anders, Lange Aksel, Rittig Soeren, Kamperis Konstantinos
Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark.
Case Rep Gastroenterol. 2015 Jan 17;9(1):20-4. doi: 10.1159/000373884. eCollection 2015 Jan-Apr.
We herein describe two children who presented with attacks of severe cyclic vomiting. The primary case was a 2.5-year-old girl with a history of several admissions with vomiting and altered mental status. She was diagnosed with cyclic vomiting syndrome (CVS). During her attacks she developed significant hyponatremia on several occasions, which prompted us to measure plasma arginine vasopressin (AVP) levels during attacks. We found inappropriately high AVP levels with concomitant hyponatremia. We also measured plasma AVP and plasma sodium in another child with CVS who did not develop manifest hyponatremia but showed inappropriately elevated plasma AVP levels. Since the standard treatment of CVS consists of fluids, high plasma AVP levels may lead to dilutional hyponatremia. We would therefore like to emphasize the importance of close assessment of electrolyte levels in patients with CVS to avoid water intoxication.
我们在此描述两名患有严重周期性呕吐发作的儿童。首例是一名2.5岁女孩，有多次因呕吐和精神状态改变入院的病史。她被诊断为周期性呕吐综合征（CVS）。在发作期间，她多次出现显著的低钠血症，这促使我们在发作期间测量血浆精氨酸加压素（AVP）水平。我们发现AVP水平异常升高并伴有低钠血症。我们还测量了另一名患有CVS但未出现明显低钠血症但血浆AVP水平异常升高的儿童的血浆AVP和血浆钠。由于CVS的标准治疗包括补液，高血浆AVP水平可能导致稀释性低钠血症。因此，我们想强调密切评估CVS患者电解质水平以避免水中毒的重要性。
