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Clinical analysis of 103 cases of tuberculous meningitis complicated with hyponatremia in adults

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Abstract

Objective

Tuberculous meningitis (TBM) is a common infection of the central nervous system. TBM with hyponatremia is very common. If hyponatremia is not treated properly, it might affect the outcome of TBM patients.

Methods

We included 226 patients diagnosed with TBM who were admitted from August 2010 to August 2015 and retrospectively analyzed the clinical data of patients with and without hyponatremia.

Results

In total, 45.6% (103/226) patients had hyponatremia and 54.4% (123/226) patients did not have hyponatremia. Serum sodium and severity of TBM were independent prediction factors of poor outcomes in TBM. The prognosis of patients with hyponatremia was worse than that of patients without hyponatremia. The mortality was 3.9% (4/103) in the hyponatremia group, while 0% (0/123) in the non-hyponatremia group. The degree of hyponatremia was related to imaging, cerebrospinal fluid (CSF) cell count and protein, severity of TBM, time to correct hyponatremia, and prognosis. We analyzed the causes of hyponatremia and found syndrome of inappropriate secretion of antidiuretic hormone (SIADH) was the most common cause (77.7%, 80/103), followed by cerebral salt wasting (CSW) (17.5%, 18/103). Comparing SIADH and CSW, there was a significant difference in mean blood pressure, albumin, and hematocrit, and no significant difference in demographic characteristics, imaging, CSF cell count and protein, severity, occurrence and correction time of hyponatremia, or prognosis.

Conclusion

TBM with hyponatremia was dominated by moderate hyponatremia, which often manifested as SIADH. The more severe hyponatremia was, the longer the correction time of hyponatremia, which will affect the prognosis of TBM patients.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Funding

This work was supported by Joint Medical Research Project of Chongqing Science & Technology and Health Commission (2020FYYX081), High-Level Medical Reserved Personnel Training Project of Chongqing, KuanRen Outstanding Young Talent Program (KY2019Y006), and Natural Science Foundation of Chongqing (cstc2020jcyj-msxmX0058).

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Author notes

  1. Qinglin Ye and Xi Peng contributed equally to this work.

Authors and Affiliations

  1. Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China

    Qinglin Ye, Xiaogang Zhang, Qingqing Cao, Kaiyan Tao & Liang Wang

  2. Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China

    Xi Peng

  3. Chongqing Key Laboratory of Neurodegenerative Diseases, Department of Neurology, Chongqing General Hospital, University of Chinese Academy of Sciences, Chongqing, China

    Xiaogang Zhang

  4. Department of Neurology, Chongqing Bishan District People’s Hospital, Chongqing, China

    Qingqing Cao

Authors
  1. Qinglin Ye
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  2. Xi Peng
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  3. Xiaogang Zhang
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Corresponding author

Correspondence to Liang Wang.

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Ethical approval

This study was approved by the Ethics Committee of the First Affiliated Hospital of Chongqing Medical University. Written consent was waived, as this retrospective study does not influence the health care of included individuals. All patients’ data were anonymized.

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The authors declare no competing interests.

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Ye, Q., Peng, X., Zhang, X. et al. Clinical analysis of 103 cases of tuberculous meningitis complicated with hyponatremia in adults. Neurol Sci 43, 1947–1953 (2022). https://doi.org/10.1007/s10072-021-05592-6

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  • DOI: https://doi.org/10.1007/s10072-021-05592-6

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