European Journal of Pediatrics

, Volume 159, Issue 7, pp 500–502

The hyponatraemic hypertensive syndrome in a 2-year-old child with behavioural symptoms

  • Peter Dahlem
  • Jaap W. Groothoff
  • Daniel C. Aronson

DOI: 10.1007/s004310051318

Cite this article as:
Dahlem, P., Groothoff, J. & Aronson, D. Eur J Pediatr (2000) 159: 500. doi:10.1007/s004310051318


In this case report we present a 2-year-old girl with the classical signs of the hyponatraemic hypertensive syndrome. She initially presented with a history of behavioural abnormalities and hyponatraemia (126 mmol/l) and her blood pressure was as high as 220/160 mmHg. After admission, somnolence developed. Intravenous antihypertensive therapy was started immediately. The hyponatraemia was treated with i.v. sodium supplementation. The cause of this syndrome proved to be fibromuscular dysplasia of the left renal artery. Finally, a left nephrectomy was performed. With this therapy, blood pressure and serum sodium normalised and the girl promptly regained normal consciousness and behaviour.

Conclusion Behavioural abnormalities in the history of a child without any other neurological symptoms might be one of the first signs of hypertensive encephalopathy. In combination with hyponatraemia, these symptoms should alert the physician to consider the hyponatraemic hypertensive syndrome.

Key words Renal artery stenosisHyponatraemiaRenovascular hypertensionBehavioural symptoms

Copyright information

© Springer-Verlag Berlin Heidelberg 2000

Authors and Affiliations

  • Peter Dahlem
    • 1
  • Jaap W. Groothoff
    • 2
  • Daniel C. Aronson
    • 3
  1. 1.Paediatric Intensive Care Unit G8–143, Emma Children's Hospital/Academic Medical Centre, Postbus 22660, 1100 DD Amsterdam, The Netherlands e-mail:; Tel.: +31-20-5669111; Fax: +31-20-6919338NL
  2. 2.Department of Paediatrics, Emma Children's Hospital/Academic Medical Centre, Amsterdam, The NetherlandsNL
  3. 3.Department of Paediatric Surgery, Emma Children's Hospital/Academic Medical Centre, Amsterdam, The NetherlandsNL