Concurrent central diabetes insipidus and cerebral salt wasting disease in a post-operative case of craniopharyngioma: a case report

Jameel, Patel Zeeshan; Lohiya, Sham; Vagha, Keta; Ahmed, Tauheed; Pujari, Divya; Vagha, Jayant; Varma, Ashish

doi:10.1186/s12887-021-02982-9

Cited by 8 publications

(6 citation statements)

References 26 publications

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“…Patients with CSW have increased urinary sodium, polyuria, and potentially hypovolemic hyponatremia. The prevalence of CSW after craniopharyngioma surgery is up to 2.9% (Grill et al., 2014 ; Jameel et al., 2021 ), whereas the prevalence of CSW in pediatric patients with brain tumors is up to 5% (Grill et al., 2014 ; Williams et al., 2016 ).…”

Section: Discussionmentioning

confidence: 99%

Serum sodium level fluctuations following the resection of childhood‐onset craniopharyngioma

Miao,

Fan,

Peng

et al. 2024

Brain and Behavior

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BackgroundCraniopharyngiomas are low‐grade malignancies (WHO I) in the sellar region. Most cases of childhood‐onset craniopharyngioma are adamantinomatous craniopharyngioma, and neurosurgery is the treatment of choice. Affected patients have postoperative complications, including water and electrolyte disturbances, because these malignancies develop near the hypothalamus and pituitary gland. Determining postoperative serum sodium fluctuation patterns in these patients can reduce postoperative mortality and improve prognosis.ObjectiveTo measure changes in serum sodium levels in pediatric patients who underwent craniopharyngioma surgery and identify influencing factors.MethodsThis retrospective study measured the serum sodium levels of 202 patients aged 0–18 years who underwent craniopharyngioma resection in Beijing Tiantan Hospital and Beijing Children's Hospital and identified predictors of severe hyponatremia and hypernatremia.ResultsThe mean age of the cohort was 8.35 ± 4.35 years. The prevalence of hypernatremia, hyponatremia, and their severe forms (serum Na+ > 150 mmol/L and serum Na+ < 130 mmol/L) within 14 days after surgery was 66.3%, 72.8%, 37.1%, and 40.6%, respectively. The mean postoperative serum sodium level showed a triphasic pattern, characterized by two peaks separated by a nadir. Sodium levels peaked on days 2 (143.6 ± 7.6 mmol/L) and 14 (143.2 ± 6.7 mmol/L) and reached their lowest on day 6 (135.5 ± 7.5 mmol/L). A total of 31 (15.3%) patients met the diagnostic threshold for hyponatremia and hypernatremia of the triphase response, whereas 116 (57.4%) patients presented this pattern, regardless of met the diagnostic criteria or not. The prevalence of severe hyponatremia varied depending on preoperative endocrine hormone deficiency, tumor status (primary or recurrent), and surgical approach.ConclusionsSerum sodium levels after craniopharyngioma resection in children showed a triphasic pattern in most cases. The risk of postoperative hyponatremia varied depending on preoperative endocrine hormone deficiency, tumor status (primary or recurrent), and surgical approach.

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Section: Discussionmentioning

confidence: 99%

Serum sodium level fluctuations following the resection of childhood‐onset craniopharyngioma

Miao,

Fan,

Peng

et al. 2024

Brain and Behavior

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“…Therefore, if a scrotal tumor, sepsis, or intestinal obstruction are present along with an acute scrotum, a preoperative CT scan should be recommended. [23][24][25][26][27][28][29][30][31][32][33][34][35][36]…”

Section: Discussionmentioning

confidence: 99%

Management and outcome of Scrotal Abscess

Gujar¹,

Dhanvij²,

Kantode³

et al. 2022

Journal of Pharmaceutical Negative Results

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INTRODUCTION: An abscess that is either superficial or intrascrotal is known as a scrotal abscess (see illustration below). Infected hair follicles, infections from scrotal lacerations, or small scrotal procedures are the causes of the superficial scrotal abscess. An internal pus collection in the scrotum is referred to as a scrotal abscess. The skin pouch that houses the testicles is known as the scrotum. There are numerous potential causes of this illness. It could result from a bacterial infection in the urethra or bladder that is left untreated. Scrotum infection is a possibility. In addition, sexually transmitted illnesses may be the cause of the syndrome (STDs). Chlamydia and gonorrhea are a couple of STD examples. A supportive tumor that affects the outermost layers of the scrotal wall and is surrounded by erythema is known as a scrotal abscess. A small pustule or papule may typically enlarge over time with increased pain, indurations, or fluctuance as part of the history. Fever and constitutional symptoms are typically absent.Patient History: -Patient 36-year-old male admitted to the hospital patient was apparently alright 3 days back when he started complaining of pus coming out of the scrotum 3 days it was sudden in onset with progressive it was associated with pain, radiating, aggravated by physical activity and not relieved by medication. Presenting Complaints and Investigation: The patient 36-year-old male admitted to the hospital with pus coming out of his scrotum, patient was apparently alright 3 days back when he started complaining of pus coming out of his scrotum since 3 days it was sudden in onset with progressive it was associated with pain, on radiating, aggravated by physical activity and not relieved by medication. Hb-13.4, MCHV-33.6,MCV-83.6,MCH-28.1,Total RBC Count-4.76,Total Platelet Count-3.24,HCT- 39.8,Monocytes-03,USG- Right sided epididymitis with changes of cellulitis in right inguinal region reactive right-sided inguinal lymphadenopathy. Past History: No prior hospitalizations or medical or surgical illnesses in the past. The main diagnosis, therapeutic intervention, and outcome: secondary suturing secondary to incision and drainage of scrotal abscess, Treatment- injceftriaxone1gmivbd, injpiptaz4.5gmivtds, injdoxycycline10mgbd,t.doxyxyline100mgbd,t.chymoralforte2tabstds,t.zifi200mgbd,t.urgendolpbd,t.pantoprazole40mgod,t.limceeod,t.supradynod, t. dolo 650 mg od Conclusion: In order to stop the condition from progressing, it is crucial to remove abscess and pus as soon as possible and provide rapid diagnosis and treatment. Opportunities to improve results are provided through early detection and intervention.

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“…As a consequence, treatments are different, as the syndrome of inappropriate ADH secretion requires water restriction, while rehydration with sodium supplementation is fundamental in cerebral salt wasting [ 29 , 33 , 34 , 35 , 42 ]. Both diabetes insipidus and syndrome of inappropriate ADH secretion may be complicated by cerebral salt wasting [ 44 , 45 ].…”

Section: Peri and Post-surgery Endocrine Complications And Their Mana...mentioning

confidence: 99%

Endocrine Disorders in Children with Brain Tumors: At Diagnosis, after Surgery, Radiotherapy and Chemotherapy

2022

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Introduction: Brain tumors are the second most frequent type of all pediatric malignancies. Depending on their localization, patients with brain tumors may present neurological or ophthalmological symptoms, but also weight anomalies and endocrine disorders ranging from growth hormone deficiency, anomalies of puberty, diabetes insipidus to panhypopituitarism. Immediately at diagnosis, all patients with brain tumors require a complete assessment of the hypothalamic–pituitary function in order to address eventual endocrine disorders. Moreover, children and adolescents undergoing brain surgery must receive peri- and postoperative hydrocortisone stress therapy. Post-operative disorders of water homeostasis are frequent, ranging from transient diabetes insipidus, as well as syndrome of inappropriate antidiuretic hormone secretion to persistent diabetes insipidus. Late endocrine disorders may result from surgery near or within the hypothalamic–pituitary region. Pituitary deficits are frequent after radiotherapy, especially growth hormone deficiency. Thyroid nodules or secondary thyroid cancers may arise years after radiotherapy. Gonadal dysfunction is frequent after chemotherapy especially with alkylating agents. Conclusion: Early detection and treatment of specific endocrine disorders at diagnosis, perioperatively, and during long-term follow-up result in improved general and metabolic health and quality of life.

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Concurrent central diabetes insipidus and cerebral salt wasting disease in a post-operative case of craniopharyngioma: a case report

Cited by 8 publications

References 26 publications

Serum sodium level fluctuations following the resection of childhood‐onset craniopharyngioma

Serum sodium level fluctuations following the resection of childhood‐onset craniopharyngioma

Management and outcome of Scrotal Abscess

Endocrine Disorders in Children with Brain Tumors: At Diagnosis, after Surgery, Radiotherapy and Chemotherapy

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