Document Detail


Hyponatremia and syndrome of inappropriate antidiuretic hormone secretion in kawasaki disease.
MedLine Citation:
PMID:  21088754     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVES: The pathogenesis of hyponatremia (serum sodium <135 mEq/L) in Kawasaki disease (KD) remains unclear. We investigated the clinical significance of hyponatremia, and the role of interleukin (IL)-6 and IL-1β in the development of hyponatremia and syndrome of inappropriate antidiuretic hormone secretion (SIADH) in KD.
SUBJECTS AND METHODS: Fifty KD patients were prospectively enrolled and analyzed for clinical and laboratory variables according to the presence of hyponatremia or SIADH.
RESULTS: Thirteen KD patients (26%) had hyponatremia and 6 of these had SIADH. In patients with hyponatremia, the percentage of neutrophils (% neutrophils), C-reactive protein (CRP), and N-terminal pro-brain natriuretic peptide (NT-proBNP) were higher than in those without hyponatremia, while serum triiodothyronine (T3) and albumin were lower. Patients with hyponatremia had a higher incidence of intravenous immunoglobulin-resistance but this was not statistically significant. No differences existed between patients with and without SIADH with regard to clinical or laboratory variables and the incidence of IVIG-resistance. Serum sodium inversely correlated with % neutrophils, CRP, and NT-proBNP, and positively correlated with T3 and albumin. Serum IL-6 and IL-1β levels increased in KD patients and were higher in patients with hyponatremia. Plasma antidiuretic hormone increased in patients with SIADH, which tended to positively correlate with IL-6 and IL-1β levels.
CONCLUSION: Hyponatremia occurs in KD patients with severe inflammation, while increased IL-6 and IL-1β may activate ADH secretion, leading to SIADH and hyponatremia in KD.
Authors:
Goh-Woon Lim; Mina Lee; Hae Soon Kim; Young Mi Hong; Sejung Sohn
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Publication Detail:
Type:  Journal Article     Date:  2010-10-31
Journal Detail:
Title:  Korean circulation journal     Volume:  40     ISSN:  1738-5555     ISO Abbreviation:  Korean Circ J     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-11-22     Completed Date:  2011-07-14     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  101247141     Medline TA:  Korean Circ J     Country:  Korea (South)    
Other Details:
Languages:  eng     Pagination:  507-13     Citation Subset:  -    
Affiliation:
Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea.
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