Highlights
- •Hyponatremia occurred in 45% of TBM patients.
- •Cerebral salt wasting was the commonest cause of hyponatremia.
- •Cerebral salt wasting was related to the severity of TBM.
Abstract
Setting
In view of paucity of studies on predictors of hyponatremia in tuberculous meningitis
(TBM) and its influence on outcome, this study was undertaken.
Objective
To study the frequency, predictors and prognosis of hyponatremia in TBM.
Design
In this prospective hospital based study, 76 patients with TBM (definite 18 and probable
58) were enrolled. The severity of meningitis was graded as I–III and hyponatremia
as severe (<120 mEq/L), moderate (120–129 mEq/L) or mild (130–134 mEq/L). Hospital death was noted and functional outcome was assessed by modified Rankin
Scale (mRS) on discharge.
Results
34 (44.7%) TBM patients had hyponatremia (mild 3, moderate 23 and severe 8). Hyponatremia
was due to cerebral salt wasting in 17, syndrome of inappropriate secretion of antidiuretic
hormone in 3 and miscellaneous causes in 14 patients. Hyponatremia was related to
GCS score and basal exudates. Outcome of TBM was related to duration of hospitalization,
GCS score, focal deficit, mechanical ventilation, severity of TBM, age and comorbidities.
Cerebral salt wasting was related to severity of TBM.
Conclusion
Hyponatremia occurred in 44.7% of TBM patients. Cerebral salt wasting was the commonest
cause of hyponatremia and was related to the severity of TBM.
Keywords
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Article info
Publication history
Published online: June 03, 2016
Accepted:
June 2,
2016
Received in revised form:
May 27,
2016
Received:
April 11,
2016
Identification
Copyright
© 2016 Elsevier B.V. All rights reserved.
