PDF(Pubmed)
Abstract：
Reset osmostat syndrome (ROS) is characterized by a change of normal plasma osmolality threshold (decrease or increase), which leads to chronic dysnatremia (hypo- or hypernatremia). We have described a clinical case of ROS and chronic hyponatremia in a patient with chordoid glioma of the III ventricle. It is known that the patient had previously been diagnosed with hyponatremia (131-134 mmol/l). She has not hypothyroidism and hypocorticism. There is normal filtration function of the kidneys was (CKD-EPI 91.7 ml/mi/1,73m2). Urine osmolality and sodium level were studied to exclude of concentration kidney function disorder. During first three days after removal of the tumor of the third ventricle (chordoid glioma, WHO Grade II), the sodium level decreased to 119 mmol/l. Repeated infusions of 200-300 ml hypertonic 3% sodium chloride solution, gluco- and mineralocorticoid therapy was ineffective, increasing plasma sodium levels by 2-3 mmol/l with the return to the initial level during 6-8 hours. Hypopituitary disorders did not develop after surgery. With further observation, the sodium level remained within 126-129 mmol/l for 6 months after surgery. The water load test make exclude the classic syndrome of inappropriate secretion of antidiuretic hormone, and confirmed the diagnosis of RSO. Because of absence of clinical symptoms associated with hyponatremia, no medical correction was required, patient was recommended to clinical follow-up.
摘要：
复位渗透压综合征（ROS）的特征是正常血浆渗透压阈值的变化（减少或增加），导致慢性失钠症（低钠血症或高钠血症）。我们已经描述了III脑室脉络膜神经胶质瘤患者的ROS和慢性低钠血症的临床病例。已知患者先前被诊断为低钠血症（131-134mmol/l）。她没有甲状腺功能减退和低心质。肾脏的过滤功能正常（CKD-EPI91.7ml/mi/1,73m2）。研究了尿液渗透压和钠水平，以排除浓度肾功能障碍。在切除第三脑室肿瘤（脊索神经胶质瘤，世卫组织二级)，钠水平降至119mmol/l。反复输注200-300毫升高渗3％氯化钠溶液，糖皮质激素和盐皮质激素治疗无效，将血浆钠水平增加2-3mmol/l，并在6-8小时内恢复到初始水平。手术后未出现垂体功能减退。进一步观察,手术后6个月，钠水平保持在126-129mmol/l范围内。水负荷试验排除抗利尿激素分泌不当的经典综合征，并证实了RSO的诊断。由于没有与低钠血症相关的临床症状，不需要医疗纠正，建议患者进行临床随访.
