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Inappropriate arginine vasopressin levels and hyponatremia associated with cyclic vomiting syndrome

Anders Breinbjerg1, Aksel Lange1, Soeren Rittig1

  • 1Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark.

Case Reports in Gastroenterology
|March 12, 2015
PubMed

Insights

Cyclic vomiting syndrome (CVS) can cause dangerously low sodium levels due to inappropriately high arginine vasopressin (AVP) levels. Monitoring electrolytes is crucial to prevent water intoxication in these patients.

Area of Science:

  • Pediatric Gastroenterology
  • Endocrinology
  • Nephrology

Background:

  • Cyclic vomiting syndrome (CVS) is a disorder characterized by recurrent episodes of intense nausea and vomiting.
  • Standard management for CVS often involves fluid resuscitation, which can impact electrolyte balance.

Observation:

  • Two pediatric cases of severe cyclic vomiting syndrome (CVS) were studied.
  • One patient experienced significant hyponatremia during vomiting episodes.
  • Elevated plasma arginine vasopressin (AVP) levels were observed during these episodes.

Findings:

  • Inappropriately high plasma arginine vasopressin (AVP) levels were detected in children with cyclic vomiting syndrome (CVS).
  • These elevated AVP levels correlated with hyponatremia in one patient.
  • Another patient with CVS also showed elevated AVP without overt hyponatremia, suggesting a predisposition.

Implications:

  • High AVP levels in CVS patients receiving fluids may lead to dilutional hyponatremia.
  • Close monitoring of electrolyte levels, particularly sodium, is essential in managing CVS.
  • Understanding the role of AVP in CVS can help prevent complications like water intoxication.

Keywords:
HyponatremiaVasopressinVomiting

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