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Inappropriate Secretion of Natriuretic Peptides in a Patient With a Cerebral Tumor
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To the Editor: Increased plasma concentrations of atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) may occur in myocardial infarction, renal insufficiency, and hypertension.1 The increased secretion of atrial natriuretic peptides from the heart is probably a physiologic reaction to volume overload but also may be due to other mechanisms. We describe a 10-month-old girl with a cerebral tumor and excessive diuresis and natriuresis, thus fulfilling the diagnosis of a cerebral salt-wasting syndrome, as described by Cort2 in the 1950s.
Report of a Case
A pilocytic astrocytoma (World Health Organization grade I) extending cranially from the third ventricle to the pituitary gland at its most caudal extent (3.2 x 2.5 x 4.5 cm) was removed by right frontotemporal craniotomy (Figure 1). During the first 4 postoperative days, the patient developed a transient left-sided hemiparesis, tonic-clonic seizures, increased urinary output (up to 10 mL/kg per hour), and excessive urinary excretion of sodium . . . [Full Text of this Article]
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