Kawasaki disease and hyponatremia

Shin, Jae Il; Kim, Ji Eun; Lee, Jae Seung; Kim, Dong Soo; Choi, Jae Young; Sul, Jun Hui

doi:10.1007/s00467-006-0242-z

Cited by 16 publications

(19 citation statements)

References 6 publications

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“…Our present study disclosed that the prevalence of hyponatremia is nearly one third of the patients with KD, which is in agreement with the previous reports [4,10]. It has been proposed that mechanisms for hyponatremia in KD are associated with the syndrome of inappropriate antidiuretic hormone secretion (SIADH), hyponatremic dehydration, and ingestion of fluid that is hypo-osmolar relative to the fluid loss [4,8,10].…”

Section: Discussionsupporting

confidence: 94%

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Immunoglobulin preparations affect hyponatremia in Kawasaki disease

et al. 2010

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Hyponatremia frequently occurs in Kawasaki disease (KD). The aim of this study was to investigate the effect of Na content of the intravenous immunoglobulin (IVIG) preparation on serum Na levels in KD. Seventy-eight subjects, of whom 27 had hyponatremia, were split up into two groups: group A receiving IVIG preparations containing high Na (0.9%) and group B receiving IVIG preparations containing trace Na. While the data before IVIG therapy revealed no significant differences in the median serum Na between the groups, an administration of IVIG preparations increased the serum levels of Na in group A (P < 0.01) but not in group B (P > 0.05). Furthermore, the median serum Na level was significantly higher in group A than that in group B (139.0 vs 137.0 mEq/L, respectively, P < 0.01). No significant difference was found in the prevalence of coronary artery lesions between the groups. In conclusion, we should keep it in mind that the IVIG products without Na have an adverse affect on hyponatremia in KD though their efficacy seems to be equivalent to those containing high Na.

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Section: Discussionsupporting

confidence: 94%

“…This finding suggests that increased inflammatory cytokines may induce SIADH and also have direct tubular effects causing natriuresis as suggested by several authors [8,10].…”

Section: Discussionmentioning

confidence: 66%

Immunoglobulin preparations affect hyponatremia in Kawasaki disease

et al. 2010

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“…Many inflammatory cytokines, including IL-6 and IL-1 beta, are elevated during the acute phase of KD [4] and these cytokines may activate vasopressin secretion. As Dr. Lee et al pointed out, further studies are necessary to confirm the possible relationship between serum cytokines and hyponatremia due to SIADH in KD [1], and there is a need to examine the various parameters, such as plasma vasopressin levels, concentrations of serum cytokines, serum osmolality, and urinary electrolytes and osmolality.…”

mentioning

confidence: 97%

“…Sirs, I read with interest the Letter to the Editor entitled "Kawasaki disease and hyponatremia" by Lee et al [1]. The authors suggested that the syndrome of inappropriate antidiuretic hormone secretion (SIADH) was one of the causes of hyponatremia in patients with Kawasaki disease (KD) and that serum cytokines such as interleukin (IL)-6 or IL-1 beta might contribute to the development of SIADH in such circumstances [1].…”

mentioning

confidence: 99%

“…The authors suggested that the syndrome of inappropriate antidiuretic hormone secretion (SIADH) was one of the causes of hyponatremia in patients with Kawasaki disease (KD) and that serum cytokines such as interleukin (IL)-6 or IL-1 beta might contribute to the development of SIADH in such circumstances [1]. I agree with the comments of Dr. Lee et al that SIADH has sometimes been reported in KD [2,3] and cerebral vasculitis is thought to be a cause of SIADH in patients with KD [4].…”

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confidence: 99%

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