Chronic syndrome of inappropriate secretion of antidiuretic hormone in a pediatric patient after traumatic brain injury.

Chronic syndrome of inappropriate secretion of antidiuretic hormone (chronic SIADH) has been reported in adults after traumatic brain injury (TBI) but few similar cases have been reported in the pediatric population. We present a case of a 14-year-old boy who developed chronic SIADH after TBI in which caloric needs could not be adequately provided, with concomitant fluid restriction as the first line of treatment. Demeclocycline was ultimately used, which allowed for increased fluid liberalization and for provision of adequate calories. This form of therapy should be considered early in a child's course to prevent nutritional decline. Demeclocycline may be used for prolonged periods until the child's clinical condition permits fluid restriction to be effective therapy.