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Guillain−Barré syndrome and hyponatraemia
Author(s) -
Colls B. M.
Publication year - 2003
Publication title -
internal medicine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 1444-0903
DOI - 10.1046/j.1445-5994.2002.00322.x
Subject(s) - medicine , mechanical ventilation , intravenous immunoglobulins , hyponatremia , guillain barre syndrome , pediatrics , antibody , immunology
Background : Hyponatraemia is a recognized association of the Guillain−Barré syndrome (GBS) and is also known to occur after the administration of intravenous infusion of gamma globulin (IVIG), a treatment often used in management of GBS. Aims : To document serum sodium concentration in GBS patients before, during and after management procedures (including IVIG) positive pressure ventilation (PPV) and the use of medications capable of causing a low serum sodium. To consider whether pseudohyponatraemia might be a contributory factor. To assess whether hyponatraemia is a predictor of poor outcome. Methods : Clinical record audit of 84 patients with GBS admitted to Christchurch Hospital, New Zealand, over a 10‐year period. Results : Serum sodium concentration was significantly low (<133 mmol/L) in 26 of 84 (31%) patients. In 12 of these cases the hyponatraemia developed during or after IVIG, suggesting that pseudohyponatraemia was a contributing factor. Six (7%) significantly hyponatraemic patients died, but no eunatraemic or slightly hyponatraemic patient died ( P = 0.001). Six of 38 patients aged ≥50 years died, whereas none of the 46 patients aged <50 years died ( P = 0.007). Five of 19 ventilated patients died but only one of 65 non‐ventilated died ( P = 0.002). Conclusions : Significant hyponatraemia occurred in 26 (31%) of the patients, but in 12 of these it appeared likely that pseudohyponatraemia caused by IVIG was a contributing factor. Hyponatraemic patients have a poorer prognosis than eunatraemic patients, however it is difficult to separate this factor from other poor prognostic factors (older age and PPV). (Intern Med J 2003; 33: 5−9)