A young boy with recurrent headache, lethargy, and hyponatremia

作者：Cao Liyun; Wagar Elizabeth A; Meng Qing H^*

来源：Clinica Chimica Acta, 2016, 454: 46-48.

DOI：10.1016/j.cca.2015.12.038

• Headache
• Intracranial germ cell tumor
• Hyponatremia
• Osmolality

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 alpha-fetoprotein, beta- 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.

• 出版日期2016-2-15