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Am J Perinatol 1999; Volume 16(Number 8): 0385-0390
DOI: 10.1055/s-1999-6812
Copyright © 1999 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel: +1(212)760-0888 x132

Hypertension-Hyponatremia Syndrome in Neonates: Case Report and Review of Literature

Ameet S. Daftary, Sanjay K. Patole, John Whitehall
  • Department of Neonatology, Kirwan Hospital for Women, Townsville, Queensland, Australia
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Publication History

Publication Date:
31 December 1999 (online)

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ABSTRACT

-Hypertension hyponatremia syndrome occurred in a 32-week male neonate following septicemic shock on Day 9. The systolic blood pressure rose from 60 to 85 mmHg as the serum sodium dropped from 136 to 121 mmol/L associated with natriuresis, polyuria, and dehydration. Convulsions occurred at a systolic blood pressure of 102 mmHg. Investigations for hypertension revealed hyper-reninemia without cardio/renovascular or neuroendocrine abnormalities. Salt supplementation and antihypertensive therapy with captopril led to resolution of natriuresis and hyponatremia. Review of literature revealed associated renovascular pathology in all neonatal cases of the syndrome reported so far. Renal ischemia from possible renal microthrombi may have been the triggering event in our case. Decline in renin levels during follow-up favors this hypothesis.

KEYWORD

Hyper-reninism - hypertension - hyponatremia - neonates