pituitrin and Encephalitis

A previously well 21-year-old girl presented to Hospital Teluk Intan, Perak, Malaysia with a short history of fever, vomiting and altered sensorium. She was diagnosed with dengue encephalitis as her dengue NS-1 antigen was positive and her cerebrospinal fluid (CSF) dengue polymerase chain reaction (PCR) was positive with serotype DENV-2. She also had severe hyponatremia due to Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) which caused an episode of seizure. She recovered well with supportive management. SIADH and dengue encephalitis should be considered as one of the differential diagnosis in patients presenting with fever and altered sensorium especially in dengue endemic countries like Malaysia.

Topics: Adult; Dengue; Encephalitis; Female; Humans; Hyponatremia; Inappropriate ADH Syndrome; Vasopressins; Young Adult

Topics: Adolescent; Amnesia; Encephalitis; Herpes Simplex; Humans; Male; Vasopressins

Topics: Aged; Brain Stem; Cerebellar Ataxia; Cerebellar Diseases; Encephalitis; Facial Paralysis; Female; Herpes Zoster; Humans; Myoclonic Cerebellar Dyssynergia; Vasopressins

Schwartz-Bartter-syndrome as a consequence of severe cerebral alterations like bacterial and tuberculous meningitis, encephalitis, hydrocephalus and brain haemorrhage has been observed in 7 cases. Massive natriuresis is followed by marked hyponatremia and hypochloremia which may lead to an intracellular brain edema. Sodium administered even in high dosage is lost rapidly through the kidney, and does not normalize the serum level of sodium. The Schwartz-Bartter-syndrome is caused by inadequatly elevated ADH-secretion with consecutive water retention and an increase in plasma volume. Consecutively an increased excretion of sodium takes place causing a substantial loss of bound water. An analogous situation was seen in a child with neurohormonal diabetes insipidus after an overdosage of ADH, which resulted in a hypervolemia, marked hyponatremia and massive natriuresis. The increased excretion of sodium may be the result of reduced reabsorption of sodium in the proximal tubuli of the kidney, caused by a humeral natriuretic factor (the socalled "third factor"). In the serum of one of our patients an increased natriuretic activity could be shown; this is the first time in a child with Schwartz-Bartter-syndrome.

Topics: Blood Volume; Brain Diseases; Brain Edema; Cerebral Hemorrhage; Child; Chlorides; Encephalitis; Female; Humans; Hydrocephalus; Hyponatremia; Infant; Infant, Newborn; Male; Meningitis; Natriuresis; Osmolar Concentration; Syndrome; Tuberculosis, Meningeal; Vasopressins

Topics: Animals; Biological Assay; Electroencephalography; Encephalitis; Female; Humans; Mental Disorders; Middle Aged; Rats; Time Factors; Vasopressins

Topics: Adolescent; Anti-Bacterial Agents; Brain Edema; Child; Child, Preschool; Coma; Electroencephalography; Encephalitis; Female; Humans; Hyponatremia; Male; Vasopressins

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adult; Aged; Cerebrovascular Disorders; Circadian Rhythm; Creatinine; Diffuse Cerebral Sclerosis of Schilder; Encephalitis; Female; Humans; Middle Aged; Potassium; Sodium; Tuberculosis, Meningeal; Urination Disorders; Vasopressins; Water-Electrolyte Balance

Topics: Blood Chemical Analysis; Carbon Dioxide; Chlorides; Electroencephalography; Encephalitis; Encephalitis, Herpes Simplex; Herpes Simplex; Hyponatremia; Kidney Function Tests; Limbic System; Pathology; Physiology; Potassium; Sodium Chloride; Vasopressins; Water-Electrolyte Balance

Topics: Arginine Vasopressin; Clinical Laboratory Techniques; Encephalitis; Encephalitis, Herpes Simplex; Herpes Simplex; Humans; Hyponatremia; Inappropriate ADH Syndrome; Physiology; Vasopressins; Water-Electrolyte Balance