Cerebral salt wasting syndrome following atlantoaxial fracture dislocation in Down syndrome

We describe cerebral salt wasting syndrome (CSWS) in a 5-year-old female child with Down syndrome who had acute myelopathy secondary to chronic atlantoaxial subluxation and fracture dislocation of the odontoid process. The patient developed hyponatraemia associated with excessive urine output and el...

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Published inBMJ case reports Vol. 2009; no. feb19 1; p. bcr0620080135
Main Authors Abdel-Latif, Mohamed El-Amin, Chan, Patrick W-K, Goh, Adrian Yu-Teik, Lum, Lucy Chai-See
Format Journal Article
LanguageEnglish
Published England BMJ Publishing Group LTD 2009
BMJ Publishing Group
SeriesUnusual association of diseases/symptoms
Subjects
Asia
Chinese
Chloride
Down syndrome
Female
Fractures
Head injuries
Hyponatremia
Nervous system
Plasma
Salt
Sodium
Trauma
Unusual Association of Diseases/Symptoms
Urine
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Summary:We describe cerebral salt wasting syndrome (CSWS) in a 5-year-old female child with Down syndrome who had acute myelopathy secondary to chronic atlantoaxial subluxation and fracture dislocation of the odontoid process. The patient developed hyponatraemia associated with excessive urine output and elevated urine sodium concentration following her injury. An administered volume-for-volume replacement of urine loss with 0.9% sodium chloride resulted in an excellent outcome. This patient illustrates the importance of ascertaining CSWS in children with spinal cord disorders, in addition to the syndrome of inappropriate antidiuretic hormone (SIADH) secretion and diabetes insipidus (DI) commonly encountered following a central nervous system (CNS) injury, as the specific treatment approaches is clearly associated with an excellent outcome.
Bibliography:ObjectType-Article-1
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ISSN:1757-790X
1757-790X
DOI:10.1136/bcr.06.2008.0135