Where did the salt go?

Bronchiolitis is a self-limiting viral respiratory-tract-infection seen commonly in infants. Some infants require hospitalization for feeding or respiratory support. A wide range of extra-pulmonary complications such as arrhythmias, myocarditis, central apneas, seizures, and hyponatremia are uncomm...

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Main Authors: Siba Prosad Paul, Sarah Sian Hicks, Manjunath Kariyappa Sanjeevaiah, Paul Anthony Heaton
Format: Article
Language:English
Published: Hacettepe University Institute of Child Health 2017-06-01
Series:The Turkish Journal of Pediatrics
Subjects:
Online Access:https://turkjpediatr.org/article/view/999
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author Siba Prosad Paul
Sarah Sian Hicks
Manjunath Kariyappa Sanjeevaiah
Paul Anthony Heaton
author_facet Siba Prosad Paul
Sarah Sian Hicks
Manjunath Kariyappa Sanjeevaiah
Paul Anthony Heaton
author_sort Siba Prosad Paul
collection DOAJ
description Bronchiolitis is a self-limiting viral respiratory-tract-infection seen commonly in infants. Some infants require hospitalization for feeding or respiratory support. A wide range of extra-pulmonary complications such as arrhythmias, myocarditis, central apneas, seizures, and hyponatremia are uncommonly known to occur with respiratory syncytial virus (RSV) infections. We present a 4-week-old-female infant admitted with RSV bronchiolitis for feeding support by nasogastric-tube. The infant suffered unexpected desaturations and seizure-like event 30-hours post-admission. Severe hyponatremia (sodium: 114 mmol/L) was detected although cause for this remained unexplained initially. Serum sodium improved following a bolus of 2.7% hypertonic-saline. The infant subsequently needed advanced respiratory support. Around time of transfer to PICU, the infant developed abdominal distension and continued to have bilious aspirate even after 6-days. An upper gastrointestinal contrast-study confirmed malrotation; improved following surgery. Co-existence of two serious pathologies may have accounted for the hyponatremia: malrotation (possible source of sodium loss into third-space) and severe bronchiolitis (inappropriate ADH-secretion). This case highlights the importance of determining origin of hyponatremia associated with acute bronchiolitis.
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institution OA Journals
issn 0041-4301
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language English
publishDate 2017-06-01
publisher Hacettepe University Institute of Child Health
record_format Article
series The Turkish Journal of Pediatrics
spelling doaj-art-74a08fcc719645bf8763f2b0184777e82025-08-20T02:01:53ZengHacettepe University Institute of Child HealthThe Turkish Journal of Pediatrics0041-43012791-64212017-06-0159310.24953/turkjped.2017.03.020Where did the salt go?Siba Prosad Paul0Sarah Sian Hicks1Manjunath Kariyappa Sanjeevaiah2Paul Anthony Heaton3Torbay Hospital, Pediatrics, Torquay, United Kingdom.Great Western Hospital, Pediatrics, Swindon, United Kingdom.Great Western Hospital, Pediatrics, Swindon, United Kingdom.Yeovil District Hospital, Pediatrics, Yeovil, United Kingdom. Bronchiolitis is a self-limiting viral respiratory-tract-infection seen commonly in infants. Some infants require hospitalization for feeding or respiratory support. A wide range of extra-pulmonary complications such as arrhythmias, myocarditis, central apneas, seizures, and hyponatremia are uncommonly known to occur with respiratory syncytial virus (RSV) infections. We present a 4-week-old-female infant admitted with RSV bronchiolitis for feeding support by nasogastric-tube. The infant suffered unexpected desaturations and seizure-like event 30-hours post-admission. Severe hyponatremia (sodium: 114 mmol/L) was detected although cause for this remained unexplained initially. Serum sodium improved following a bolus of 2.7% hypertonic-saline. The infant subsequently needed advanced respiratory support. Around time of transfer to PICU, the infant developed abdominal distension and continued to have bilious aspirate even after 6-days. An upper gastrointestinal contrast-study confirmed malrotation; improved following surgery. Co-existence of two serious pathologies may have accounted for the hyponatremia: malrotation (possible source of sodium loss into third-space) and severe bronchiolitis (inappropriate ADH-secretion). This case highlights the importance of determining origin of hyponatremia associated with acute bronchiolitis. https://turkjpediatr.org/article/view/999RSVbronchiolitishyponatremiamalrotationseizures
spellingShingle Siba Prosad Paul
Sarah Sian Hicks
Manjunath Kariyappa Sanjeevaiah
Paul Anthony Heaton
Where did the salt go?
The Turkish Journal of Pediatrics
RSV
bronchiolitis
hyponatremia
malrotation
seizures
title Where did the salt go?
title_full Where did the salt go?
title_fullStr Where did the salt go?
title_full_unstemmed Where did the salt go?
title_short Where did the salt go?
title_sort where did the salt go
topic RSV
bronchiolitis
hyponatremia
malrotation
seizures
url https://turkjpediatr.org/article/view/999
work_keys_str_mv AT sibaprosadpaul wheredidthesaltgo
AT sarahsianhicks wheredidthesaltgo
AT manjunathkariyappasanjeevaiah wheredidthesaltgo
AT paulanthonyheaton wheredidthesaltgo