Hyponatremia in children with severe pneumonia and its effect on overall outcome

Background: Severe pneumonia is often associated with dyselectrolytemia, most commonly hyponatremia and the level of sodium significantly correlates to the overall outcome of the patient. The present study was conducted to identify the incidence of hyponatremia in children with Severe Pneumonia and to identify its association with Syndrome of Inappropriate secretion of Anti Diuretic Hormone (SIADH) and the effect on morbidity, mortality and duration of hospital stay.Methods: This study was conducted on 102 children between the age group of 6 months to 5 years admitted to the Upgraded Department of Pediatrics, Patna Medical College and Hospital with clinically and radiologically confirmed severe pneumonia from March 2017 to September 2018.Results: There were 33(32.4%) cases of hyponatremia out of which 26(25.5%), 5(4.9%) and 2(1.9%) had mild, moderate and severe hyponatremia respectively. 19(57.6%) cases of hyponatremia were due to SIADH out of which the duration of hospital stay was prolonged in 10(52.6%) cases, 10(52.6%) cases developed complications and 7(36.8%) patients died. The mortality of patients with hyponatremia was significantly higher (p<0.05) in the group with SIADH when compared to those without SIADH. The average duration of stay in hospital also was significantly higher (p<0.05) for the group with hyponatremia i.e. 8.2'4.5 days when compared to the group with normnatremia i.e. 7.3'1.7 days.Conclusions: Hyponatremia is commonly associated with Severe Pneumonia. Hyponatremia is usually mild and results in prolonged hospital stay, increased complications and mortality especially when associated with SIADH.

Dyke-Davidoff-Masson syndrome.

Dyke Davidoff Masson syndrome (DDMS) is characterized by seizures, facial asymmetry, contralateral hemiplegia and mental retardation. The characteristic radiologic features are cerebral hemiatrophy with homolateral hypertrophy of the skull and sinuses. We report a case of DDMS in an 18-month-old girl who presented with right sided focal seizures, hemiparesis of the same side, and delayed milestones.