All issues > Volume 28(5); 1985

Original Article

J Korean Pediatr Soc. 1985;28(5):415-422. Published online May 31, 1985.

Hypomatremia in children.

Youn Ok Kim, Hye Li Chung, Khun Soo Lee, Ja Hoon Koo

¹Department of Pediatrics, School of Medicine Kyungpook National University, Taegu,Korea

Abstract

A clinical study was couducted on 77 hyponatremic children who had been admitted to the Pediatric Department of Kyungpook National University Hospital from January 1983 to June 1984. The following results were obtained. Male preponderance was noted with male to female ratio of 2.2: 1 and age distribution showed an even distribution from newborn to adolescence. According :to the classification by blood volume status, euvolemic type was the most common one occupying 55.8%, followed by hypovolemic and hypervolemic types. In the newborn, underlying diseases causing hyponatremia were diarrheal isease,gastroschisis,iatrogenic water loading, acute & chronic renal failure and congestive heart failure. There also were noted diverse causes causing hyponatremia in children after newborn age. However, no single disease predominated to any particular age period in children. Twelve cases were found to have SIADH, and CNS diseases (meningitis, hypoxic encepha- lopathy and Reye syndrome) was the most common cause, followed in order of frequency by possible sepsis, infective endocarditis, post-tonsillectomy, and vincristine. Severe symptoms such as convulsion and coma were seen mainly in children having serum sodium level below 120 mEq/L. However,all the children with serum sodium level above 126 mEq/L were asymptomatic. With conventional therapy including sodium administration (and fluid restriction in case of SIADH), serum sodium returned to normal within 24 hours in 52.9% of cases. However, one case with SIADH caused by vincristine needed DOCA administration due to- intractable hyponatremia lasting over 7 days. Prognosis showed complete recovery in 54 cases and incomplete recovery (seizures necessitating anticonvulsant medication) in 3. Death or hopeless discharge seen in 20 cases was thought to be due to the underlying diseases rather than hyponatremia itself.

Keywords :Hyponatremia; SIADH