Department of Pediatrics, Leiden University Medical Center, Leiden, Netherlands.
Division of Pediatric Endocrinology, Department of Pediatrics, Leiden University Medical Centre, Leiden, Netherlands.
J Neonatal Perinatal Med. 2020;13(2):283-285. doi: 10.3233/NPM-180149.
Hyponatremia is a common laboratory finding in premature and ill neonates. When the degree of hyponatremia is more severe, the likelihood of a pathologic entity increases. In this case report we describe a premature neonate with severe hyponatremia due to the idiopathic syndrome of inappropriate antidiuretic hormone secretion (SIADH).
The patient is a male neonate, born prematurely. He was admitted to the neonatal intensive care unit and received non-invasive respiratory support. After 48 hours of life serum sodium (Na+) decreased to 115 mmol/l. Hyponatremia progressively worsened despite aggressive Na+ supplementation. The clinical and laboratory data were most consistent with severe SIADH. Fluid restriction was initiated which resulted in a gradual normalization of Na+. A causal factor for development of SIADH could not be identified.
When a neonate presents with significant hyponatremia that is not responsive to conventional therapy, it is important to perform a diagnostic work-up for SIADH, even in the absence of overt triggering factors.
低钠血症是早产儿和患病新生儿的常见实验室发现。当低钠血症的程度更严重时，病理性实体的可能性增加。在本病例报告中，我们描述了一例因抗利尿激素分泌不当综合征（SIADH）而导致严重低钠血症的早产儿。
患儿为男性早产儿，出生时早产。他被收入新生儿重症监护病房并接受无创呼吸支持。出生后 48 小时，血清钠（Na+）降至 115mmol/l。尽管积极补充 Na+，低钠血症仍逐渐加重。临床和实验室数据最符合严重 SIADH。开始限制液体摄入，导致 Na+逐渐正常化。未能确定导致 SIADH 发展的因果因素。
当新生儿出现对常规治疗无反应的显著低钠血症时，即使没有明显的触发因素，也有必要对 SIADH 进行诊断性检查。
