Hyponatremia and Syndrome of Inappropriate Antidiuretic Hormone Secretion in Kawasaki Disease.
10.4070/kcj.2010.40.10.507
- Author:
Goh Woon LIM
1
;
Mina LEE
;
Hae Soon KIM
;
Young Mi HONG
;
Sejung SOHN
Author Information
1. Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea. sohn@ewha.ac.kr
- Publication Type:Original Article
- Keywords:
Hyponatremia;
Inappropriate antidiuretic hormone syndrome;
Kawasaki disease;
Interleukins
- MeSH:
C-Reactive Protein;
Humans;
Hyponatremia;
Inappropriate ADH Syndrome;
Incidence;
Inflammation;
Interleukin-6;
Interleukins;
Mucocutaneous Lymph Node Syndrome;
Natriuretic Peptide, Brain;
Neutrophils;
Peptide Fragments;
Plasma;
Prospective Studies;
Sodium;
Triiodothyronine
- From:Korean Circulation Journal
2010;40(10):507-513
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND AND OBJECTIVES: The pathogenesis of hyponatremia (serum sodium <135 mEq/L) in Kawasaki disease (KD) remains unclear. We investigated the clinical significance of hyponatremia, and the role of interleukin (IL)-6 and IL-1beta in the development of hyponatremia and syndrome of inappropriate antidiuretic hormone secretion (SIADH) in KD. SUBJECTS AND METHODS: Fifty KD patients were prospectively enrolled and analyzed for clinical and laboratory variables according to the presence of hyponatremia or SIADH. RESULTS: Thirteen KD patients (26%) had hyponatremia and 6 of these had SIADH. In patients with hyponatremia, the percentage of neutrophils (% neutrophils), C-reactive protein (CRP), and N-terminal pro-brain natriuretic peptide (NT-proBNP) were higher than in those without hyponatremia, while serum triiodothyronine (T3) and albumin were lower. Patients with hyponatremia had a higher incidence of intravenous immunoglobulin-resistance but this was not statistically significant. No differences existed between patients with and without SIADH with regard to clinical or laboratory variables and the incidence of IVIG-resistance. Serum sodium inversely correlated with % neutrophils, CRP, and NT-proBNP, and positively correlated with T3 and albumin. Serum IL-6 and IL-1beta levels increased in KD patients and were higher in patients with hyponatremia. Plasma antidiuretic hormone increased in patients with SIADH, which tended to positively correlate with IL-6 and IL-1beta levels. CONCLUSION: Hyponatremia occurs in KD patients with severe inflammation, while increased IL-6 and IL-1beta may activate ADH secretion, leading to SIADH and hyponatremia in KD.
