vasopressin hypersecretion syndrome in children
Introduction
Introduction to hypersecretion syndrome in children Hypersecretion of vasopressin syndrome (hypersecretion of vasopressinsyndrome), a common abnormality of water and sodium metabolism caused by increased secretion of vasopressin (AVP), is an increase in plasma AVP concentration, blood sodium reduction, water retention, osmotic pressure abnormalities Low, a syndrome caused by intracellular edema, used to be called cerebral hyponatremia. basic knowledge The proportion of illness: 0.0025% Susceptible people: children Mode of infection: non-infectious Complications: convulsions in children
Cause
Pediatric vasopressin hypersecretion syndrome etiology
(1) Causes of the disease
This disease often occurs in diseases affecting the central nervous system, including meningitis, encephalitis, brain tumors, brain abscess, subarachnoid hemorrhage, infectious polyradiculitis, head trauma, acute intermittent porphyria , pneumonia, tuberculosis and the use of positive pressure breathing apparatus; there are cancers such as pancreatic cancer, duodenal cancer and oat cell cancer in lung cancer; drugs such as morphine, pethidine (Du Lengding) can appear; A small number of cases may be due to dysfunction of osmotic receptor function or failure to find a cause.
(two) pathogenesis
Under the above circumstances, the underlying cause of AVP regulation disorder is still unclear. It may be that the lesion affects the hypothalamic function. Cancer cells can secrete AVP. When the cancer is inhibited, the symptoms disappear, morphine, peti Acridine (Du Lengding) can excite the secretion of AVP, which can cause this syndrome after surgery.
Prevention
Prevention of hypersecretion syndrome in children with vasopressin
1. Actively prevent and treat various infectious diseases such as encephalitis, meningitis, brain abscess, pneumonia, tuberculosis, infectious polyradiculitis and so on.
2. Strengthen care to prevent brain trauma.
3. Prevention and treatment of various cancers to improve the environment, comprehensive management, and actively prevent and treat various cancers and tumors.
Complication
Pediatric vasopressin secretion syndrome complications Complications
Water poisoning and convulsions can occur.
Symptom
Pediatric vasopressin hypersecretion syndrome symptoms common symptoms nausea and vomiting convulsions appetite is poor, reflexes disappeared, water poisoning confusion
Most cases are recessive, blood sodium is generally normal or low, clinically asymptomatic, in the occurrence of the above diseases or drug stimulation, symptoms appear, manifested as low humoral osmotic pressure and water toxicity, blood sodium reduced to 120mmol / L (120mEq / L) below, symptoms such as loss of appetite, nausea, vomiting, restlessness, personality change and confusion; blood loss at <110mmol/L (110mEq/L), sputum reflex disappears, and convulsions can occur Normal blood pressure, no dehydration, low blood chlorine, normal bicarbonate concentration, sodium in the urine in the case of hyponatremia, urine is also diluted to hypotonic, but higher than serum osmotic pressure, kidney and Adrenal function is normal.
Examine
Examination of hypersecretion syndrome in children
Serum sodium was significantly lower than normal, more than <120mmol / L, blood chlorine is also lower than normal, HCO3- normal; white blood cell count and neutrophils in peripheral blood increased significantly when infected; other depending on the original cause of the disease.
X-ray chest X-ray, brain CT, B-ultrasound, etc. were selected according to clinical needs.
Diagnosis
Diagnosis and differentiation of vasopressin hypersecretion syndrome in children
Based on the above clinical manifestations, combined with laboratory and auxiliary examinations for comprehensive judgment.
It is differentiated from hyponatremia caused by insufficient sodium supply and loss of gastrointestinal tract.
