Central salt loss syndrome

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Classification according to ICD-10
E87.1 Hypoosmolality and hyponatremia
E23.3 Hypothalamic dysfunction, not elsewhere classified
ICD-10 online (WHO version 2019)

The central salt loss syndrome (syn. Cerebral salt loss syndrome) is a rare syndrome that occurs due to a malfunction of the "central nervous system" with severe damage to the brain and requires intensive medical treatment. It is characterized by a resulting high loss of sodium chloride via the kidneys and by the resulting hyponatremia in the blood combined with a lack of blood volume .

The syndrome was first described in 1950 by John Punnett Peters (1887–1955) and his colleagues.

root cause

Triggers can be, for example, a subarachnoid hemorrhage as a result of a stroke or a traumatic brain injury . The syndrome has also been observed in the context of gliomas , tuberculosis and meningiosis carcinomatosa ( meningeal involvement in tumors ).

The actual cause is assumed to be a disturbance in the function of the hypothalamus , in the context of which a disturbance in the excretion of the atrial natriuretic factor occurs. At the same time, a change in the Brain Natriuretic Peptide in the blood can also be detected in the clinical picture . The exact pathomechanism is still not understood.

therapy

In contrast to the Schwarz-Bartter syndrome (dilution hyponatremia), in the case of the "central salt loss syndrome" the compensation of the lost volume by means of isotonic saline solution is paramount. The therapy can also be supplemented with fludrocortisone with the aim of increasing sodium reabsorption in the kidneys. Intensive care monitoring is absolutely necessary.

Individual evidence

  1. ↑ P. Reuter: The Great Reuter. Birkhäuser, 2005, ISBN 3-540-25104-9 , p. 1219, (online) .
  2. ↑ a b c d A. Hartmann: The stroke. Birkhäuser, 2001, ISBN 3-7985-1211-6 , p. 347, (online) .
  3. ↑ a b c M. Tisdall et al .: Disturbances of sodium in critically ill adult neurologic patients: a clinical review. In: Journal of Neurosurgical Anesthesiology . 2006 January; 18 (1), pp. 57-63, PMC 1513666 (free full text).
  4. ↑ JP Peters et al .: A salt-wasting syndrome associated with cerebral disease , PMC 14855556 (free full text).
  5. ↑ D. Steube: Psychogenic polydipsia after traumatic brain injury - a rare complication. In: Neurol Rehabil. 2006; 12 (6), pp. 335-338, (online) .