Hyponatremic dehydration: An analysis of 78 cases

Abstract

Our purpose was to determine thefrequency of convulsion in children withhyponatremic dehydration (HD). We alsoinvestigated whether or not there was arelationship between the severity ofhyponatremia and the degrees of malnutrition inour region (Eastern Anatolia of Turkey) inwhere malnutrition is frequently observed.In this study, the clinical and laboratoryfindings of 78 patients with diarrhoea (acute,persistent or chronic diarrhoea) and HD werestudied. When diarrhoea lasts longer than 2 and4 weeks they were accepted as persistent andchronic diarrhoea, respectively. Patients weresaid to have HD if they had the clinicalfindings of dehydration associated withhyponatremia [Serum sodium (SNa)<130 mmol/L)]. Nutritional status of thechildren was assessed by the Gomezclassification using weight for age; it wasaccepted as normal those were between90%–110%, mild malnutrition 75%–89%,moderate malnutrition 60%–74% and severemalnutrition <60%. Of 78 patients, 40 wereboys, 38 were girls. The age and weight of thepatients ranged from 40 days to 36 months(8.94 ± 5.49 months) and from 2000 to 10300 g(5535.25 ± 1702.10 g) respectively. Allpatients except four had malnutrition; 15(20.3%) had mild malnutrition, 30 (40.5%) hadmoderate malnutrition and 29 (39.2%) hadsevere malnutrition. Forty-seven patients hadacute, 16 patients had persistent, and 15patients had chronic diarrhoea. SNa levels werebetween 104 and 129 mmol/L(121.21 ± 6.12 mmol/L). There was notstatistically a significant difference betweenSNa level and the degree of malnutrition, andSNa level and the types (acute, persistent orchronic) of diarrhoea (p > 0.05). Of 78patients, 12 (15.3%) patients had convulsion,of whom eight had convulsion associated withfever. Convulsion was noted in nine (19.1%)and three (18.7%) patients with acute andpersistent diarrhoea, respectively (p > 0.05).Also, we observed that when hyponatremia wasseverer, convulsions tended to be more occuring(p < 0.05). Five (6.4%) children died and allof them had severe malnutrition and septicemia.We determined that the frequency of convulsionin HD was 15.3% (12/78), and there was not adifference between the cases of acute,persistent and chronic diarrhoea for thefrequency of convulsion. We also found asignificant difference was not present betweenSNa level and the degree of malnutrition, andbetween SNa level and the types (acute,persistent or chronic) diarrhoea. However, weobserved that when hyponatremia was severer,convulsions tended to be more occuring.