Abstract
5 children with acute brain disease showed heavy urinary salt losses which were considered related to the cerebral lesions as renal and adrenal function was unimpaired. Lowest serum Na levels were 110-118 mval/L, lowest C1 levels 69-82 mval/L, serum K was normal. NaCl administered in large amounts did not raise serum Na but was excreted in the urine. Symptoms of dehydratation were absent; plasma volume blood pressure and serum N were normal. Red cell volume was increased by 20-30%. Symptoms of water intoxication in accordance with analogous intracellular oedema in the brain were observed in 2 cases and were temporarily relieved by NaCl infusions. -Presumably the disorder corresponds to the syndrome of Schwartz & Bartter which is characterised by enhanced endogenous ADH production and water retention. The heavy salt losses are considered as the results of a compensatory “3rd factor” activity. Determinations of ADH, renin, 3rd factor and aldosterone will be reported. Similar findings-water retention, hyponatriaemia, increased urinary NaCl excretion-were observed in a girl with diabetes insipidus treated by Pitressin, two large doses.
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Bierich, J., Muller, M. INVESTIGATIONS IN CHILDREN WITH CEREBRAL SALT LOSING SYNDROME. Pediatr Res 8, 135 (1974). https://doi.org/10.1203/00006450-197402000-00052
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DOI: https://doi.org/10.1203/00006450-197402000-00052