中枢性塩喪失症候群
WordNet
- sprinkle as if with salt; "the rebels had salted the fields with mines and traps"
- a compound formed by replacing hydrogen in an acid by a metal (or a radical that acts like a metal)
- preserve with salt; "people used to salt meats on ships"
- the taste experience when common salt is taken into the mouth (同)saltiness, salinity
- white crystalline form of especially sodium chloride used to season and preserve food (同)table_salt, common salt
- (of speech) painful or bitter; "salt scorn"- Shakespeare; "a salt apology"
- add salt to
- add zest or liveliness to; "She salts her lectures with jokes"
- of or relating to the cerebrum or brain; "cerebral hemisphere"; "cerebral activity"
- involving intelligence rather than emotions or instinct; "a cerebral approach to the problem"; "cerebral drama" (同)intellectual
- a pattern of symptoms indicative of some disease
- a complex of concurrent things; "every word has a syndrome of meanings"
- (used especially of meats) preserved in salt (同)salt-cured, brine-cured
PrepTutorEJDIC
- 〈U〉『塩』食塩 / 〈U〉(化学で)塩 / 《複数形で》薬用塩類(Epsom salt[s],smelling salts) / 〈U〉生気(刺激,興趣)を与えるもの / 〈C〉《話》(特に老練な)水夫 / 塩の,塩を含んでいる;塩気のある,塩辛い / 塩漬けにした / (土地が)塩につかった / 塩信でできた,塩水の中で育つ / 〈食べ物〉‘を'塩で味をつける;〈肉・魚など〉‘を'塩漬けにして保存する《+『名』+『down』,+『down』+『名』》 / 《受動態で》(…で)〈言葉・話なで〉‘を'ぴりっとさせる,‘に'味をつける《+『名』+『with』+『名』》
- 大脳の,脳の / 頭脳的な,知的な
- (疾患の徴候となる一群の)症徴候,症候群 / (事件・社会的状態などのパターンを示す)徴候形態
- 衰弱(荒廃)させる
- 塩で味をつけて,塩味の;塩漬けの
Wikipedia preview
出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/11/23 22:38:17」(JST)
[Wiki en表示]
| Cerebral salt-wasting syndrome |
| Classification and external resources |
| DiseasesDB |
32234 |
| eMedicine |
ped/354 |
Cerebral salt-wasting syndrome (CSWS) is a rare endocrine condition featuring a low blood sodium concentration and dehydration in response to trauma/injury or the presence of tumors in or surrounding the brain. This form of low blood sodium is due to excessive sodium excretion from the normally functioning kidney due to a disorder of the cerebrum of the brain.[1] The condition was initially described in 1950.[2]
Contents
- 1 Signs and symptoms
- 2 Causes and Diagnosis
- 3 Treatment
- 4 References
Signs and symptoms
Signs and symptoms of CSWS include large amounts of urination (at least 3 liters of urine output over a 24 hour period for adults) due to inadequate sodium retention in the body, high amounts of sodium in the urine,[1] low blood sodium concentration,[1] excessive thirst, extreme salt cravings, dysfunction of the autonomic nervous system, and dehydration. Patients often self-medicate by naturally gravitating toward a high-sodium diet and by dramatically increasing their water intake. Advanced symptoms include muscle cramps, lightheadedness, dizziness or vertigo, feelings of anxiety or panic (not mentally induced), increased heart rate or slowed heart rate, low blood pressure and orthostatic hypotension sometimes resulting in fainting.[3] Other symptoms frequently associated with dysautonomia include: headaches, pallor, malaise, facial flushing, constipation or diarrhea, nausea, acid reflux, visual disturbances, numbness, nerve pain, trouble breathing, chest pains, loss of consciousness and seizures.[3]
Causes and Diagnosis
CSWS is usually caused by brain injury/trauma or cerebral lesion, tumor, or hematoma. CSWS is a diagnosis of exclusion and may be difficult to distinguish from the syndrome of inappropriate antidiuretic hormone (SIADH), which develops under similar circumstances and also presents with hyponatremia.[1] The main clinical difference is that of total fluid status of the patient: CSWS leads to a relative or overt low blood volume whereas SIADH is consistent with a normal or high blood volume.[1] If blood-sodium levels increase when fluids are restricted, SIADH is more likely.[4]
Treatment
While CSWS usually appears within the first week after brain injury and spontaneously resolves in 2–4 weeks, it can sometimes last for months or years. In contrast to the use of fluid restriction to treat SIADH, CSWS is treated by replacing the urinary losses of water and sodium with hydration and sodium replacement.[1] The mineralocorticoid medication fludrocortisone can also improve the low sodium level.[1][5]
References
- ^ a b c d e f g Yee AH, Burns JD, Wijdicks EF (April 2010). "Cerebral salt wasting: pathophysiology, diagnosis, and treatment". Neurosurg Clin N Am 21 (2): 339–52. doi:10.1016/j.nec.2009.10.011. PMID 20380974.
- ^ Peters JP, Welt LG, Sims EA, Orloff J, Needham J (1950). "A salt-wasting syndrome associated with cerebral disease". Trans. Assoc. Am. Physicians 63: 57–64. PMID 14855556.
- ^ a b Tierney, Lawrence M.; McPhee, Stephen J.; Papadakis, Maxine A. (2006). Current Medical Diagnosis and Treatment 2007 (Current Medical Diagnosis and Treatment). McGraw-Hill Professional. p. 1010. ISBN 0-07-147247-9.
- ^ Harrigan MR (1996). "Cerebral salt wasting syndrome: a review". Neurosurgery 38 (1): 152–60. doi:10.1097/00006123-199601000-00035. PMID 8747964.
- ^ Betjes MG (2002). "Hyponatremia in acute brain disease: the cerebral salt wasting syndrome". Eur J Intern Med 13 (1): 9–14. doi:10.1016/S0953-6205(01)00192-3. PMID 11836078.
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Endocrine pathology: endocrine diseases (E00–E35, 240–259)
|
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Pancreas/
glucose
metabolism |
| Hypofunction |
- types:
- type 1
- type 2
- MODY 1 2 3 4 5 6
- complications
- coma
- angiopathy
- ketoacidosis
- nephropathy
- neuropathy
- retinopathy
- cardiomyopathy
- insulin receptor (Rabson–Mendenhall syndrome)
- Insulin resistance
|
|
| Hyperfunction |
- Hypoglycemia
- beta cell (Hyperinsulinism)
- G cell (Zollinger–Ellison syndrome)
|
|
|
Hypothalamic/
pituitary axes |
| Hypothalamus |
- gonadotropin
- Kallmann syndrome
- Adiposogenital dystrophy
- CRH (Tertiary adrenal insufficiency)
- vasopressin (Neurogenic diabetes insipidus)
- general (Hypothalamic hamartoma)
|
|
| Pituitary |
| Hyperpituitarism |
- anterior
- Acromegaly
- Hyperprolactinaemia
- Pituitary ACTH hypersecretion
- posterior (SIADH)
- general (Nelson's syndrome)
|
|
| Hypopituitarism |
- anterior
- Kallmann syndrome
- Growth hormone deficiency
- ACTH deficiency/Secondary adrenal insufficiency
- GnRH insensitivity
- FSH insensitivity
- LH/hCG insensitivity
- posterior (Neurogenic diabetes insipidus)
- general
- Empty sella syndrome
- Pituitary apoplexy
- Sheehan's syndrome
- Lymphocytic hypophysitis
|
|
|
| Thyroid |
| Hypothyroidism |
- Iodine deficiency
- Cretinism
- Congenital hypothyroidism
- Myxedema
- Euthyroid sick syndrome
|
|
| Hyperthyroidism |
- Hyperthyroxinemia
- Thyroid hormone resistance
- Familial dysalbuminemic hyperthyroxinemia
- Hashitoxicosis
- Thyrotoxicosis factitia
- Graves' disease
|
|
| Thyroiditis |
- Acute infectious
- Subacute
- De Quervain's
- Subacute lymphocytic
- Autoimmune/chronic
- Hashimoto's
- Postpartum
- Riedel's
|
|
| Goitre |
- Endemic goitre
- Toxic nodular goitre
- Toxic multinodular goiter
|
|
|
| Parathyroid |
| Hypoparathyroidism |
- Hypoparathyroidism
- Pseudohypoparathyroidism
- Pseudopseudohypoparathyroidism
|
|
| Hyperparathyroidism |
- Primary
- Secondary
- Tertiary
- Osteitis fibrosa cystica
|
|
|
| Adrenal |
| Hyperfunction |
- aldosterone: Hyperaldosteronism/Primary aldosteronism
- Conn syndrome
- Bartter syndrome
- Glucocorticoid remediable aldosteronism
- AME
- Liddle's syndrome
- 17α CAH
- cortisol: Cushing's syndrome (Pseudo-Cushing's syndrome)
- sex hormones: 21α CAH
- 11β CAH
|
|
Hypofunction/
Adrenal insufficiency
(Addison's, WF) |
- aldosterone: Hypoaldosteronism
|
|
|
| Gonads |
- ovarian: Polycystic ovary syndrome
- Premature ovarian failure
- testicular: enzymatic
- 5α-reductase deficiency
- 17β-hydroxysteroid dehydrogenase deficiency
- aromatase excess syndrome)
- Androgen receptor (Androgen insensitivity syndrome
- general: Hypogonadism (Delayed puberty)
- Hypergonadism
- Hypoandrogenism
- Hypoestrogenism
- Hyperandrogenism
- Hyperestrogenism
|
|
|
| Height |
- Dwarfism/Short stature
- Midget
- Laron syndrome
- Psychosocial
- Ateliosis
- Gigantism
|
|
| Multiple |
- Autoimmune polyendocrine syndrome multiple
- Carcinoid syndrome
- Multiple endocrine neoplasia
- Progeria
- Werner syndrome
- Acrogeria
- Metageria
- Woodhouse-Sakati syndrome
|
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|
|
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noco (d)/cong/tumr, sysi/epon
|
proc, drug (A10/H1/H2/H3/H5)
|
|
|
|
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Water-electrolyte imbalance and acid-base imbalance (E86–E87, 276)
|
|
| Volume status |
- Volume contraction (Dehydration/Hypovolemia)
- Hypervolemia
|
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| Electrolyte |
| Na+ |
- Hypernatremia
- Hyponatremia (Hypotonic, Isotonic)
|
|
| K+ |
|
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| Cl− |
- Hyperchloremia
- Hypochloremia
|
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| Ca++ |
- Hypercalcaemia
- Hypocalcaemia
|
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| Acid-base |
| Acidosis |
- Metabolic: High anion gap (Ketoacidosis/Diabetic ketoacidosis, Lactic)
- Normal anion gap (Hyperchloremic, Renal tubular)
|
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| Alkalosis |
- Metabolic: Contraction alkalosis
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| Both |
- Mixed disorder of acid-base balance
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|
|
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noco/acba/cong/tumr, sysi/epon, urte
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proc/itvp, drug (G4B), blte, urte
|
|
|
|
UpToDate Contents
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English Journal
- Hyponatremia After Spontaneous Aneurysmal Subarachnoid Hemorrhage-A Prospective Observational Study.
- Ridwan S, Zur B, Kurscheid J, Esche J, Kristof R, Klingmüller D, Boström A.
- World neurosurgery. 2019 Sep;129()e538-e544.
- Hyponatremia has been frequently observed after aneurysmal subarachnoid hemorrhage (SAH), and some data have suggested a correlation with symptomatic cerebral vasospasm and poor outcomes. The present prospective study investigated sodium and water disturbances after aneurysmal SAH with regard to sym
- PMID 31154098
- [Cerebral salt wasting syndrome as a complication of subarachnoid hemorrhage in a girl with nephrotic syndrome - a case report].
- Skrzypczyk P, Tachasiuk K, Szymanik-Grzelak H, Mizerska-Wasiak M, Szymańska K, Brzewski M, Pańczyk-Tomaszewska M.
- Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego. 2019 Aug;47(278)72-75.
- Cerebral salt wasting syndrome (CSWS), characterized by natriuresis, polyuria, and hypovolemia, is a rare complication of central nervous system injury or disease. 12-year-old girl was admitted with second attack of nephrotic syndrome (NS). On admission she presents with edema, blood pressure 110/60
- PMID 31473757
Japanese Journal
- 西尾 元伸,西谷 信之,田中 惠子
- 臨床神経学 = Clinical neurology 54(8), 657-659, 2014-08
- NAID 40020180971
- 西尾 元伸,西谷 信之,田中 惠子
- 臨床神経学 54(8), 657-659, 2014
- … 症例は36歳の女性である．精神症状にて発症した．髄液検査にて細胞数と蛋白の上昇をみとめ，臨床経過から辺縁系脳炎と診断した．経過中に著明な低Na血症をみとめ水分制限をおこなったが改善せず，Naと水分の補充により低Na血症の改善をみとめ中枢性塩類喪失症候群（cerebral salt wasting syndrome; …
- NAID 130004679009
Related Links
- Cerebral salt wasting syndrome 告示 番号：67 疾病名：中枢性塩喪失症候群 疾患概念・定義 中枢神経疾患罹患時あるいは罹患後に、低ナトリウム血症を来すことがある。 その主たる病因として、ADH不適切分泌症候群（SIADH）が挙げられる。 SIADHでは、ADHが不適切に多く分泌されるため、水分貯留を来す。 一方、尿中の塩排泄が亢進し、細胞外液が減少して低ナトリウム血症と脱水症を来した状態を、中枢性塩喪失症候群（CSW）と呼び、SIADHと区別している。 SIADHでも、貯留した水分を排泄しようとして、尿中Na排泄が増加する。 SIADHの診断に、尿中Naが20 mEq/lが含まれているのはこのためである。
- 中枢性塩類喪失症候群 中枢性塩類喪失症候群（cerebral salt wasting syndrome：CSWS）は、頭部外傷や脳外科手術に伴って低ナトリウム血症を呈する病態です。 ナトリウム利尿ペプチド（ANP/BNP）の放出や、腎への遠心性交感神経刺激の障害に起因するレニンおよびアルドステロン濃度の低下が、腎臓でのナトリウム再吸収を阻害して低ナトリウム血症と体液（細胞外液）量の低下をきたすと考えられます。 SIADHは、抗利尿ホルモン（ADH）の不適切な分泌により水利尿不全をきたし、その結果二次的にナトリウム排泄が亢進して体液（細胞外液）がほぼ正常の低ナトリウム血症を呈します。
- Cerebral salt wasting is characterized by hyponatremia with elevated urine sodium and hypovolemia. In the current literature, professionals debate if cerebral salt wasting is a distinct condition or a special form of the syndrome of inappropriate secretion of antidiuretic hormone (SIADH).
★リンクテーブル★
[★]
- 英
- cerebral salt-wasting syndrome
- 関
- SIADH
[★]
-
- wasting of the masseter, temporal and sternomastoid muscles(咬筋、側頭筋、胸鎖乳突筋の筋萎縮)
- 関
- atrophic, consumption, exhaust, exhaustion, exhaustive, marantic, marasmus, waste
[★]
- 関
- brain、cerebri、cerebro、cerebrum、encephalic、encephalo、encephalon
[★]
- 関
- saline
[★]