TY - JOUR
T1 - A young boy with recurrent headache, lethargy, and hyponatremia
AU - Cao, Liyun
AU - Wagar, Elizabeth A.
AU - Meng, Qing H.
N1 - Publisher Copyright:
© 2015 Elsevier B.V.
PY - 2016/2/15
Y1 - 2016/2/15
N2 - Background: To investigate and differentiate the causes of hyponatremia in an 8-y old boy. Methods: An 8-y boy presented with headache, vomiting, and diplopia. Magnetic resonance imaging of the brain confirmed a mass in the pineal region. Pathology report demonstrated a mixed germ cell tumor with a yolk sac component. A multi-agent chemotherapy and radiation regimen was initiated. He developed hyponatremia, with sodium concentrations varying from 116 to 133. mEq/l. Results: Serum levels of sodium, chloride, phosphorous, uric acid, and osmolality were low. Serum α-fetoprotein, β-HCG, and lactate dehydrogenase were highly elevated. Urine sodium and osmolality were increased. Conclusions: These presentations suggest that the patient has cerebral salt-wasting syndrome caused by intracranial germ cell tumor. Recognition and differentiation of cerebral salt-wasting syndrome from other disorders are essential.
AB - Background: To investigate and differentiate the causes of hyponatremia in an 8-y old boy. Methods: An 8-y boy presented with headache, vomiting, and diplopia. Magnetic resonance imaging of the brain confirmed a mass in the pineal region. Pathology report demonstrated a mixed germ cell tumor with a yolk sac component. A multi-agent chemotherapy and radiation regimen was initiated. He developed hyponatremia, with sodium concentrations varying from 116 to 133. mEq/l. Results: Serum levels of sodium, chloride, phosphorous, uric acid, and osmolality were low. Serum α-fetoprotein, β-HCG, and lactate dehydrogenase were highly elevated. Urine sodium and osmolality were increased. Conclusions: These presentations suggest that the patient has cerebral salt-wasting syndrome caused by intracranial germ cell tumor. Recognition and differentiation of cerebral salt-wasting syndrome from other disorders are essential.
KW - Headache
KW - Hyponatremia
KW - Intracranial germ cell tumor
KW - Osmolality
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U2 - 10.1016/j.cca.2015.12.038
DO - 10.1016/j.cca.2015.12.038
M3 - Article
C2 - 26747959
AN - SCOPUS:84952950962
SN - 0009-8981
VL - 454
SP - 46
EP - 48
JO - Clinica Chimica Acta
JF - Clinica Chimica Acta
ER -