inappropriate adh syndrome

Changes in the body fluid and serum electrolyte status following major operations, such as brain tumor resection, are always expected. These changes can increase post-operation morbidity and mortality.

We aimed to evaluate the changes in serum electrolyte levels and renal function parameters in brain tumor patients after operation.

This cross-sectional study was performed on 168 patients with supratentorial tumors in Poursina Hospital, Rasht City, Iran, in 2020. The study parameters included patients’ demographics, hemodynamic stability, serum sodium, potassium, blood urea nitrogen (BUN) and creatinine levels, urine specific gravity, and urinary output, measured immediately and 12 hours after the operation.

This study revealed statistically significant increases in serum sodium level (from 139.70±5.60 meq/L to 140.34±6.23 meq/L, P=0.002), urinary output (from 1043.70±455.00 mL to 1967.50±661.10 mL, P=0.008), urine specific gravity (from 1.010±0.007 to 1.012±0.008, P=0.011), and in serum BUN level (from 17.46±6.92 to 18.41±6.40, P=0.001), but significant decrease in serum potassium level (from 3.88±0.49 meq/L to 3.78±0.28 meq/L, P=0.017) during the first 12 hours after operation. However, the change in serum creatinine level was not significant (from 1.18±2.08 mg/dL to 1.17±2.08 mg/dL, P=0.787).

Significant changes in serum electrolytes (sodium and potassium) and renal function indicators (urine output, specific gravity, and serum BUN) are expected within the first 12 hours after brain tumor operation.

SLE (Systemic Lupus Erythematosus) is an autoimmune disorder with a range of symptoms and an unclear cause. Infections,which are one of the leading causes of death in SLE patients, are made more possible by immunosuppressive medications. It isyet unclear how Cytomegalovirus (CMV) infection affects SLE. Clinically, differentiating between an infection and a lupusflare-up is critical. For this reason, we discuss the case of a 56-year-old woman who was hospitalized to Loghman Hospital'srheumatic clinic with SLE and CMV infection.

Brucellosis is a zoonotic infection with high distribution all over the world and has many clinical manifestations, one of which is neurobrucellosis (NB).. Our case was a 78-year-old man who presented acute decreased level of consciousness, acute parkinsonism signs and hyponatremia due to syndrome of inappropriate antidiuretic hormone secretion (SIADH), which was caused by brucellosis.. Neurobrucellosis is a rare presentation of brucellosis and should be considered when neurological problems cannot be explained by other etiology especially in endemic areas..