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Evaluation of Hyponatremia in Children

Differential diagnosis and emergency management of low serum sodium in pediatrics.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Çocuk Sağlığı ve Hastalıkları department. Book Appointment →

What is Evaluation of Hyponatremia in Children?

Hyponatremia (serum sodium < 135 mEq/L) is the most common electrolyte abnormality in childhood. It is classified by volume status as hypovolemic, euvolemic, or hypervolemic.

Acute hyponatremia developing within 48 hours can cause cerebral edema and seizures. SIADH (syndrome of inappropriate ADH secretion), hypotonic IV fluid administration, and gastroenteritis are the most frequent causes. Correction must be controlled to prevent osmotic demyelination syndrome.

Symptoms

Nausea and vomiting
Headache
Confusion and lethargy
Seizures when sodium falls below 120 mEq/L
Coma in severe hyponatremia
Muscle cramps

Risk Factors

Gastroenteritis and dehydration
Hypotonic intravenous fluid administration
SIADH — meningitis, pneumonia, central nervous system disease
Adrenal insufficiency
Excessive water intake — psychogenic polydipsia
Diuretic use

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Sodium below 130 mEq/L on laboratory testing
  • Neurological symptoms — seizure or altered mental status — emergency
  • Lethargy or agitation during gastroenteritis
  • Postoperative hyponatremia

Treatment Methods

01
Acute symptomatic management — 3 percent NaCl 2 to 5 mL per kg IV bolus when seizures are present
02
Correction rate of no more than 10 to 12 mEq/L per 24 hours
03
Hypovolemic — isotonic 0.9 percent saline infusion
04
SIADH — fluid restriction
05
Treatment of the underlying cause
06
Serial sodium monitoring every 2 to 4 hours during the acute phase

Which Department to Visit?

You can visit our Çocuk Sağlığı ve Hastalıkları department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Çocuk Sağlığı ve Hastalıkları Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.