Krishnan Sowmya, Deshpande Swapna, Mallappa Ashwini, Divya Gunda, Lane Pascale, Vishwanath Anu, McNall-Knapp Rene Y
Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
Department of Psychiatry, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
Case Rep Pediatr. 2017;2017:3757423. doi: 10.1155/2017/3757423. Epub 2017 Jan 9.
Chronic hyponatremia is very rare in children and is often seen in the setting of congestive heart failure or liver failure in adults. Here, we report an 8-year-old child with hypothalamic glioma who presented with severe hyponatremia. Initial management consisted of fluid restriction. This was very difficult for the child to follow and the child developed bizarre drinking habits requiring intervention from child psychiatry. So therapy was initiated with low dose V2 receptor antagonist under close inpatient monitoring. While initial response was reassuring, her sodium levels tended to drift down with longer duration of treatment requiring us to increase the dose frequently. Her response to therapy and her stable clinical situation off therapy suggest that she may have reset osmostat.
慢性低钠血症在儿童中非常罕见，在成人中常出现在充血性心力衰竭或肝功能衰竭的情况下。在此，我们报告一名8岁患有下丘脑胶质瘤的儿童，其出现了严重低钠血症。初始治疗包括限制液体摄入。这对该儿童来说很难遵循，并且该儿童养成了怪异的饮水习惯，需要儿童精神病学进行干预。因此，在密切的住院监测下开始使用低剂量V2受体拮抗剂进行治疗。虽然初始反应令人安心，但随着治疗时间延长，她的钠水平趋于下降，这要求我们频繁增加剂量。她对治疗的反应以及治疗停止后的稳定临床状况表明她可能已经重置了渗透压感受器。
