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Cerebral Salt-Wasting Syndrome in a Patient With Active Pulmonary Tuberculosis
Waqas Memon1, Ayesha Akram2,3, Karishma Popli4
1Internal Medicine/Nephrology, University of Virginia, Lynchburg, USA.
Cureus
|February 15, 2022
Summary
A patient with tuberculosis and an intracranial lesion developed severe hyponatremia. Treatment involved careful fluid and sodium management, highlighting the importance of recognizing salt-wasting syndrome.
Area of Science:
- Neurology
- Infectious Diseases
- Nephrology
Background:
- A 37-year-old female with active pulmonary tuberculosis and an intracranial lesion presented with neurological symptoms.
- Her medical history complicated the diagnostic and management pathway.
Observation:
- The patient presented with altered mental status, nausea, and vomiting.
- Initial examination showed a euvolemic state, but laboratory results revealed a critical serum sodium concentration of 105 mEq/L.
Findings:
- The patient was managed with intravenous fluids including lactated ringer and 3% normal saline, followed by oral sodium chloride and fluid restriction.
- Despite initial stabilization, she experienced dizziness, raising concerns for salt-wasting syndrome.
Implications:
- This case underscores the potential for severe hyponatremia in patients with tuberculosis and intracranial lesions.
- Prompt recognition and tailored management of electrolyte imbalances, such as salt-wasting syndrome, are crucial for patient outcomes.
Keywords:
active pulmonary tuberculosiscerebral salt-wasting syndromediabetes insipidusnephrologysiadhMore Related Videos
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