Successful Use of Fludrocortisone in a Child with Refractory Cerebral Salt Wasting Syndrome: A Case Report and Review of Literature

Shilpa Gurnurkar; Sindy Villacres; Lindsey Warner; Madhuradhar Chegondi

doi:10.7759/cureus.3505

$Successful Use of Fludrocortisone in a Child with Refractory Cerebral Salt Wasting Syndrome: A Case Report and Review of Literature$

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Successful Use of Fludrocortisone in a Child with Refractory Cerebral Salt Wasting Syndrome: A Case Report and Review of Literature

Shilpa Gurnurkar, Sindy Villacres, Lindsey Warner and Madhuradhar Chegondi

Curēus (Palo Alto, CA), Vol.10(10), p.e3505

10/27/2018

DOI: 10.7759/cureus.3505

PMCID: PMC6318137

PMID: 30648045

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Abstract

Hyponatremia post-neurosurgical intervention can be dangerous and potentially life-threatening. Two of its most common causes are cerebral salt wasting (CSW) and syndrome of inappropriate anti-diuretic hormone release (SIADH). CSW is proposed to be secondary not only to the elevated levels of circulating atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) but inhibition of steroidogenesis in the zona glomerulosa of the adrenal cortex, thus resulting in mineralocorticoid deficiency. We present a two-year-old male who had developed acute hyponatremia secondary to CSW on post-operative day two after a sub-total resection of a low-grade juvenile pilocytic astrocytoma (WHO grade I). Fludrocortisone was successfully used to manage the refractory hyponatremia and alleviated the need to use very large amounts of oral sodium supplementation.

cerebral salt wasting

child

Diabetes

Endocrinology

fludrocortisone

Metabolism

Pediatrics

Details

Title: Subtitle: Successful Use of Fludrocortisone in a Child with Refractory Cerebral Salt Wasting Syndrome: A Case Report and Review of Literature
Creators: Shilpa Gurnurkar - Nemours Foundation
Sindy Villacres - Nemours Foundation
Lindsey Warner - University of Central Florida
Madhuradhar Chegondi - University of Iowa
Resource Type: Journal article
Publication Details: Curēus (Palo Alto, CA), Vol.10(10), p.e3505
DOI: 10.7759/cureus.3505
PMID: 30648045
PMCID: PMC6318137
NLM abbreviation: Cureus
ISSN: 2168-8184
eISSN: 2168-8184
Publisher: Cureus
Language: English
Date published: 10/27/2018
Academic Unit: Stead Family Department of Pediatrics
Record Identifier: 9984354515002771

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