SUN-068 A CASE OF CEREBRAL SALT WASTING - DIAGNOSTIC AND; MANAGEMENT CHALLENGE.AND IMPORTANCE OF MASS MONITORING

摘要

Introduction: Hypotonic Hyponatremia remains the commonest dyse-lectrolytemia. The condition and its correction is associated with sig-nificant morbidity & serious outcomes like death or permanentdisability. The classical evaluation of hyponatremia favours over-diag-nosisofSIADH.Anewnovelclassificationwasproposedbyusin2016toimprove diagnostic workup and not to miss diagnosis of entities likeSyndrome of Hyper Responsiveness to ADH.and Reset Osmostat etc.Another difficulty faced is differentiation between SIADH & cerebralsalt wasting. Either of these could occur in patient of brain surgery orbrain pathology. Both present with similar urine & blood parameters butdiffer in having normal blood volume versus contracted blood volume.While SIADH required fluid restriction, doing so in CSW could bedetrimental. Here we present a a case of symptomatic severe hypotonichyponatremia which with the application of mass balance of water andsalt could be diagnosed correctly to be due to Cerebral Salt wasting. Thatfacilitated correct management of the patient and good outcome.