A young boy with recurrent headache, lethargy, and hyponatremia.

Academic Article

Abstract

  • 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.
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    Keywords

  • Headache, Hyponatremia, Intracranial germ cell tumor, Osmolality, Antineoplastic Combined Chemotherapy Protocols, Child, Diagnosis, Differential, Headache, Humans, Hyponatremia, Inappropriate ADH Syndrome, Lethargy, Magnetic Resonance Imaging, Male, Neoplasms, Germ Cell and Embryonal
  • Digital Object Identifier (doi)

    Author List

  • Cao L; Wagar EA; Meng QH
  • Start Page

  • 46
  • End Page

  • 48
  • Volume

  • 454