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pediatric hyponatremia

Manisha Balwani, Preeti Singh, Anju Seth, Ekta Malik Debnath, Hetanshi Naik, Dana Doheny, Brenden Chen, Makiko Yasuda, Robert J Desnick
Acute Intermittent Porphyria (AIP), an autosomal dominant inborn error of heme metabolism, typically presents in adulthood, most often in women in the reproductive age group. There are limited reports on the clinical presentation in children, and in contrast to the adults, most of the reported pediatric cases are male. While acute abdominal pain is the most common presenting symptom in children, seizures are commonly seen and may precede the diagnosis of AIP. As an example, we report a 9year old developmentally normal pre-pubertal boy who presented with acute abdominal pain, vomiting and constipation followed by hyponatremia, seizures, weakness and neuropathy...
October 15, 2016: Molecular Genetics and Metabolism
Shikha Shukla, Srikanta Basu, Michael L Moritz
AIM: To evaluate maintenance intravenous fluid-prescribing practices and the incidence of hospital-acquired hyponatremia in children admitted to a general pediatric ward. METHODS: This is a prospective observational study conducted over a 2-month period in children ages 2 months to 5 years who were admitted to a general pediatric ward and who were receiving maintenance intravenous fluids. The composition, rate, and duration of intravenous fluids were chosen at the discretion of the treating physician...
2016: Frontiers in Pediatrics
Min Jeong Han, Soon Chul Kim, Chan Uhng Joo, Sun Jun Kim
RATIONALE FOR THIS CASE REPORT: Cerebral Salt-Wasting Syndrome (CSWS) is characterized by hyponatremia and sodium wasting in the urine. These conditions are triggered by various neurosurgical disorders such as subarachnoid hemorrhage, brain tumor, head injury, and brain surgery. To our knowledge, CSWS caused by Wernicke encephalopathy (WE) has been rarely reported. PRESENTING CONCERNS OF THE PATIENT: A 2-year-old male patient presented to our hospital due to a seizure attack...
September 2016: Medicine (Baltimore)
Fredrick Ibinda, Hans-Christoph Zarnack, Charles R Newton
BACKGROUND: Perturbations of blood sodium are the most frequently encountered electrolyte disorder in sick children, and may influence fluid therapy. We examined the frequency of blood sodium perturbations, and factors and outcomes associated with hyponatremia in children admitted to a rural Kenyan hospital and investigated the risk factors associated with deaths in hyponatremic children. METHODS: Plasma sodium levels and other laboratory parameters were measured in children admitted to a rural Kenyan hospital...
2016: PloS One
Wen-Xiong Chen, Hong-Sheng Liu, Si-Da Yang, Si-Hui Zeng, Yuan-Yuan Gao, Zhi-Hong Du, Xiao-Jing Li, Hai-Sheng Lin, Hui-Ci Liang, Jian-Ning Mai
OBJECTIVE: To describe clinical features of reversible splenial lesion syndrome (RESLES) in children. METHODS: Retrospectively analyzed clinical features of RESLES in children and compared differences between severe and non-severe group, classified by clinical global impression-scale; summarized clinical features of children with mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) from case series. RESULTS: 16 episodes of RESLES occurring in 15 Chinese children were analyzed, with 13 episodes having MERS and 3 episodes with epilepsy...
November 2016: Brain & Development
Thomas B Alexander, Norman J Lacayo, John K Choi, Raul C Ribeiro, Ching-Hon Pui, Jeffrey E Rubnitz
PURPOSE: To characterize the toxicity, pharmacokinetics, and pharmacodynamics of selinexor, a selective inhibitor of nuclear export, when combined with fludarabine and cytarabine, in children with relapsed or refractory leukemia. PATIENTS AND METHODS: Eighteen patients with relapsed or refractory acute leukemia were enrolled in the SELHEM (Selinexor With Fludarabine and Cytarabine for Treatment of Refractory or Relapsed Leukemia or Myelodysplastic Syndrome) clinical trial (NCT02212561)...
August 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Mohammad Javad Ghabouli Shahroodi, Kiarash Ghazvini, Reza Sadeghi, Mohammad Saeed Sasan
BACKGROUND: The highest incidence of meningitis occurs during the neonatal period and (then) infancy. Although Bacterial agents are the most dangerous cause of neonatal and childhood meningitis yet viruses especially, enteroviruses (EV), are by far the most common cause of meningitis in this age group. OBJECTIVES: The aim of the current study was to evaluate the role of EVs in neonatal and childhood meningitis in the Mashhad city of Iran. MATERIALS AND METHODS: This was a descriptive study that was performed at Imam Reza hospital in a period of six months (March to September 2007), during which all of the cerebral spinal fluid (CSF) samples from the neonatal intensive care unit (NICU) and pediatrics ward were collected and real time-polymerase chain reaction (RT-PCR) for EVs was done on these samples...
May 2016: Jundishapur Journal of Microbiology
Kioomars Golshekan, Hamidreza Badeli, Mahboube Miri, Maryam Mirzaie, Afagh Hassanzadeh Rad, Fatemeh Salamat, Sepideh Abdi Tazeabadi, Nahid Bidar, Kobra Blouki-Moghaddam, Houman Hashemian
INTRODUCTION: Gastroenteritis (GE) is one of the most common pediatric diseases. Hyponatremia commonly occurs by administering hypotonic fluids to GE and hospitalized children. Yet, there is no consensus on the ideal method of treatment. OBJECTIVES: we aimed to assess suitable intravenous (IV) fluid for preventing dysnatremia in children with GE. PATIENTS AND METHODS: This is a double blind randomized clinical trial, which was conducted on infants of 6 months up to 14 years children with GE...
2016: Journal of Renal Injury Prevention
Kentaro Ouchi, Kazuna Sugiyama
BACKGROUND: Reportedly, administration of hypotonic fluids containing 30.8-74 mEq/L sodium with 5 % glucose may lead to serious hyponatremia or hyperglycemia. In Japan, hypotonic fluids containing 90 mEq/L sodium with 2.6 % glucose are commonly used. We compared blood electrolyte balance and blood glucose concentration with the use of isotonic (140 mEq/L sodium with 1 % glucose) versus hypotonic fluids in pediatric patients. METHODS: We studied 77 children aged 5 months to 2 years who underwent oro-maxillofacial surgery and dental treatment under general anesthesia...
July 27, 2016: BMC Pediatrics
Moran Hausman-Kedem, Shimon Reif, Dana Danino, Rona Limor, Zachary M Grinspan, Anat Yerushalmi-Feler, Amir Ben-Tov, Amir Birger
OBJECTIVE: Hyponatremia is a well-known sequela of community-acquired pneumonia (CAP). B-type natriuretic peptide (BNP) has a natriuretic effect and was found to be elevated in patients with CAP. We investigated whether BNP has a role in the pathophysiology of hyponatremia in pediatric CAP. METHODS: Serum and urine electrolytes and osmolality, as well as NT-pro-BNP (N-BNP), were obtained in 49 hospitalized pediatric patients with CAP (29 with hyponatremia, 20 with normal sodium levels...
May 31, 2016: Pediatric Emergency Care
Dinesh Kumar Narayanasamy, Arul Kumaran Arunagirinathan, Revathi Krishna Kumar, V D Raghavendran
OBJECTIVE: To study the clinical and laboratory profile of pediatric scrub typhus in rural south India. METHODS: This is a descriptive study of the clinical and laboratory features of 117 children with IgM ELISA proven scrub typhus out of 448 children, who were admitted in the Pediatric ward of a tertiary care hospital, during the study period of November 2014 through March 2015. RESULTS: Fever was present in all 117 children, with mean duration of fever at admission as 9 d...
June 29, 2016: Indian Journal of Pediatrics
Teresa Genoni, Rossana Tenconi, Giuseppe Bertolozzi, Emanuela Anna Laicini, Giacomo Tardini, Federica Vianello, Ernesto Leva, Gregorio Paolo Milani, Emilio Filippo Fossali
A 21-month-old boy came to our attention because of pneumonia. His weight increased before presentation, and his blood test results showed hyponatremia (116 mEq/L), low plasma osmolarity (241 mOsm/L), and high urine osmolarity (435 mOsm/L). He was treated with 0.9% sodium chloride solution and intravenous furosemide, and sodium levels rose up to 135 mEq/L in 36 hours. No standard treatment is available for severe hyponatremia in children. The use of vaptans in pediatric patients is described in literature, but it lacks evidence about safety and effectiveness...
June 2016: Pediatric Emergency Care
Andrea Taddio, Eleonora Dei Rossi, Lorenzo Monasta, Serena Pastore, Alberto Tommasini, Loredana Lepore, Gabriele Bronzetti, Edoardo Marrani, Biancamaria D'Agata Mottolese, Gabriele Simonini, Rolando Cimaz, Alessandro Ventura
Kawasaki shock syndrome (KSS) is a rare manifestation of Kawasaki disease (KD) characterized by systolic hypotension or clinical signs of poor perfusion. The objectives of the study are to describe the main clinical presentation, echocardiographic, and laboratory findings, as well as the treatment options and clinical outcomes of KSS patients when compared with KD patients. This is a retrospective study. All children referred to two pediatric rheumatology units from January 1, 2012, to December 31, 2014, were enrolled...
May 26, 2016: Clinical Rheumatology
Dimitri Poddighe
BACKGROUND: In the context of infectious diseases, mild hyponatremia is supposed to be originated by a transient secretion of vasopressin mediated by non-osmotic stimuli. This study provides data supporting the view that mild hyponatremia during acute illnesses is related to a systemic inflammatory condition. METHODS: A total of 328 consecutive children (aged 3 months to 17 years) underwent blood testing at the Pediatric Emergency Department over a 2-month period and were retrospectively analyzed...
June 2016: Minerva Pediatrica
Vanisha Patel, Ashwin Subramani Krishna, Cassandra Lefevre, Mildred Kaagaza, Michael Wittkamp
OBJECTIVE: Attention deficit hyperactivity disorder (ADHD) is an increasingly common diagnosis of childhood that manifests with symptoms that affect cognitive, academic, behavioral, emotional, and social functioning. There are a multitude of pharmaceutical therapies to choose from when managing this condition, and though many studies on the safety and efficacy of these medications have been published, adverse effects still occur. CASE: This case discusses a previously healthy 8-year-old boy who had been prescribed 20-mg lisdexamfetamine dimesylate for ADHD however mistakenly took his brother's 36-mg methylphenidate extended-release tablets, resulting in hyperhidrosis, excessive thirst, polydipsia, and combative behavior that began within 3 hours of ingestion...
April 26, 2016: Pediatric Emergency Care
Amy Lynn A Teleron, Brandon K Rose, David M Williams, Suzanne E Kemper, James E McJunkin
BACKGROUND: La Crosse viral encephalitis is well described in children, but to date, there are only 2 adult cases described in the literature. Despite the fact that pediatric infection can be life threatening and typically presents as a febrile meningoencephalitis often complicated by seizures and mental status changes, little is known about the presentation and course of adult infection. We report the largest case series of adult La Crosse encephalitis. METHODS: Inpatient data were reviewed between 2001 and 2012 to identify adults (≥18 years of age) with possible La Crosse encephalitis...
August 2016: American Journal of Medicine
Urban Fläring, Kerstin Sandström, Krister Nilsson
Hyponatremia is the most frequent electrolyte abnormality seen postoperatively in pediatric patients receiving maintenance fluid therapy. Hyponatremia is also common in acute pediatric illness. The main factors contributing to hyponatremia in these conditions are increased secretion of antidiuretic hormone (ADH) and routine use of sodium hypotonic fluids. An increased ADH secretion results in an impaired ability to excrete free water. If the sodium concentration falls to less than 125 mmol/L hyponatremic encephalopathy might develop, resulting in cerebral edema...
2016: Läkartidningen
Norishi Ueda
Background.  There is no literature review on gastroduodenal perforation or ulcer (GDPU) with rotavirus (RV) and norovirus (NoV) gastroenteritis. Methods.  Pediatric cases of GDPU or upper gastrointestinal bleeding with RV and NoV gastroenteritis were searched from September 1974 until October 2015 using PubMed, Google for English, other-language-publications, and Ichushi ( for Japanese-language publications. All reports confirming GDPU or upper gastrointestinal bleeding with RV and NoV gastroenteritis were eligible for inclusion in the study...
January 2016: Open Forum Infectious Diseases
Sarah Depallens, Nicolas Lutz, Raffaella Carlomagno, Blaise Meyrat, Mirjam Schuler Barazzoni, Yves Yamgoue Tchameni, Andres Pascual, François Scerba, Andrea Superti-Furga
Every pediatrician will be confronted with newborns oryoung infants with skin lesions in proximity of the vertebral column. It is important not to miss a spinal dysraphism because of the risk of meningeal infection or of the possible presence of a tethered cord. A practical algorithm is presented. Non-accidental injury in young infants and toddlers is not rare but difficult to detect. Bruises and fractures are highly suspicious for non-accidental injury and should trigger specific investigations. Emergency departments and hospitals are switching from hypotonic to isotonic solutions as maintenance infusions of children...
January 13, 2016: Revue Médicale Suisse
Niu Li, Juan Li, Yu Ding, Tingting Yu, Yongnian Shen, Qihua Fu, Yiping Shen, Xiaodong Huang, Jian Wang
Aldosterone synthase deficiency (ASD) is a rare, autosomal recessive inherited disease. Mutations in the CYP11B2 gene are responsible for the occurrence of ASD, and the clinical manifestations of ASD vary with age. Affected infants may develop symptoms of mineralocorticoid deficiency, including clinical presentation with frequent vomiting, a variable degree of hyponatremia, hyperkalemia, and metabolic acidosis combined with poor growth, which are easily confused with several other endocrine genopathies, including pseudohypoaldosteronism type 1 and congenital adrenal hyperplasia...
April 2016: Molecular Medicine Reports
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