Liangos Orfeas, Madias Nicolaos E
KfH Nierenzentrum Lichtenfels.
University of Würzburg Faculty of Medicine, Würzburg, Germany, and.
Clin Nephrol Case Stud. 2021 Feb 19;9:4-10. doi: 10.5414/CNCS110146. eCollection 2021.
Cerebral salt wasting (CSW) is an uncommon cause of hyponatremia characterized by extracellular volume depletion, high urine sodium concentration and osmolality, and low serum uric acid concentration in association with central nervous system (CNS) disease. Distinguishing CSW from the syndrome of inappropriate secretion of antidiuretic hormone (SIADH), a much more common form of hyponatremia in this setting, can be challenging because both present with identical laboratory features. However, treatment of CSW and SIADH differs, making a correct diagnosis important. Here we present a case of CSW in a 75-year-old man in whom severe hyponatremia and volume depletion were discovered in the setting of traumatic head injury and Dandy-Walker malformation of the brain, a rare congenital brain malformation. Treatment with intravenous normal saline and later oral salt supplementation and fludrocortisone was successful.
脑性盐耗综合征（CSW）是低钠血症的一种罕见病因，其特征为细胞外液容量减少、尿钠浓度和渗透压升高、血清尿酸浓度降低，并伴有中枢神经系统（CNS）疾病。在这种情况下，将CSW与抗利尿激素分泌不当综合征（SIADH）相鉴别可能具有挑战性，因为二者具有相同的实验室特征，而SIADH是低钠血症更常见的形式。然而，CSW和SIADH的治疗方法不同，因此做出正确诊断很重要。在此，我们报告一例75岁男性的CSW病例，该患者在创伤性脑损伤和丹迪-沃克畸形（一种罕见的先天性脑畸形）的情况下出现严重低钠血症和容量耗竭。静脉输注生理盐水，随后口服补盐及使用氟氢可的松治疗取得成功。
