Neonatal Medicine

  • 제25권3호
  • /
  • Pages.131-135
  • /
  • 2018
  • /
  • 2287-9412(pISSN)
  • /
  • 2287-9803(eISSN)
대한신생아학회 (The Korean Society of Neonatology)
권호 표지
DOI QR코드

DOI QR Code

A Rare Case of Hyponatremia Caused by Reset Osmostat in a Neonate with Cleft Lip, Cleft Palate, and Imperforate Anus

  • Ahn, Jung Gu (Department of Pediatrics, Division of Pediatric Surgery, Inje University Busan Paik Hospital, Inje University College of Medicine) ;
  • Lee, Jeong Eun (Department of Pediatrics, Division of Pediatric Surgery, Inje University Busan Paik Hospital, Inje University College of Medicine) ;
  • Chung, Woo Yeong (Department of Pediatrics, Division of Pediatric Surgery, Inje University Busan Paik Hospital, Inje University College of Medicine) ;
  • Koo, Soo Hyun (Department of Pediatrics, Division of Pediatric Surgery, Inje University Busan Paik Hospital, Inje University College of Medicine) ;
  • Shin, Jaeho (Department of Surgery, Inje University Busan Paik Hospital, Inje University College of Medicine) ;
  • Jeon, Ga Won (Department of Pediatrics, Division of Pediatric Surgery, Inje University Busan Paik Hospital, Inje University College of Medicine)
  • 투고 : 2018.06.08
  • 심사 : 2018.08.13
  • 발행 : 2018.08.31
⟨ 이전 논문 다음 논문 ⟩

초록

Hyponatremia is defined as a plasma sodium concentration of <135 mEq/L. It is a common electrolyte imbalance in newborns. We report the case of a term neonate with cleft lip, cleft palate, imperforate anus, normal male karyotype, and chronic hyponatremia. On the 4th day of life, he showed hyponatremia (plasma sodium concentration 130 mEq/L) with low serum osmolality (275 mOsm/kg), high urine sodium (116.7 mEq/L), and high urine osmolality (412 mOsm/kg). His thyroid and adrenal functions were normal. Despite intravenous and oral sodium supplementation and hydrocortisone treatment, hyponatremia persisted. Brain magnetic resonance imaging showed normal results. He was diagnosed as having reset osmostat, a rare subtype of the syndrome of inappropriate secretion of antidiuretic hormone characterized by a subnormal threshold for antidiuretic hormone secretion, with hypotonic hyponatremia.

키워드

참고문헌

  1. Marcialis MA, Dessi A, Pintus MC, Irmesi R, Fanos V. Neonatal hyponatremia: differential diagnosis and treatment. J Matern Fetal Neonatal Med 2011;24 Suppl 1:75-9. https://doi.org/10.3109/14767058.2011.607667
  2. Baylis PH. The syndrome of inappropriate antidiuretic hormone secretion. Int J Biochem Cell Biol 2003;35:1495-9. https://doi.org/10.1016/S1357-2725(03)00139-0
  3. Bartter FC, Schwartz WB. The syndrome of inappropriate secretion of antidiuretic hormone. Am J Med 1967;42:790-806. https://doi.org/10.1016/0002-9343(67)90096-4
  4. Vale BM, Morais S, Mesquita J, Mimoso G. Reset osmostat: a rare cause of hyponatraemia. BMJ Case Rep 2015;2015:bcr2013009111.
  5. Marcialis MA, Dessi A, Contu S, Fanos V. Nephrogenic syndrome of inappropriate antidiuresis: a novel cause of euvolemic hypotonic hyponatremia in newborns. Diagnosis and practical management. J Matern Fetal Neonatal Med 2009;22 Suppl 3:67-71. https://doi.org/10.1080/14767050903196037
  6. Thiagarajan R, La Gamma E, Dey S, Blethen S, Wilson TA. Hyponatremia caused by a reset osmostat in a neonate with cleft lip and palate and panhypopituitarism. J Pediatr 1996;128:561-3. https://doi.org/10.1016/S0022-3476(96)70371-2
  7. Moritz ML, Ayus JC. Hyponatremia in preterm neonates: not a benign condition. Pediatrics 2009;124:e1014-6. https://doi.org/10.1542/peds.2009-1869
  8. Gupta P, Mick G, Fong CT, Jospe N, McCormick K. Hyponatremia secondary to reset osmostat in a child with a central nervous system midline defect and a chromosomal abnormality. J Pediatr Endocrinol Metab 2000;13:1637-41.
  9. Modi N. Hyponatraemia in the newborn. Arch Dis Child Fetal Neonatal Ed 1998;78:F81-4. https://doi.org/10.1136/fn.78.2.F81
  10. Chehade H, Rosato L, Girardin E, Cachat F. Inappropriate antidiuretic hormone secretion: long-term successful urea treatment. Acta Paediatr 2012;101:e39-42. https://doi.org/10.1111/j.1651-2227.2011.02382.x