Inappropriate secretion of antidiuretic hormone in children with bacterial meningitis

A prospective study of bacterial meningitis in children was initiated two years ago. Serum sodium concentrations below 135 mEq/l were noted on admission in 72 of 124 (58.1%) of patients enrolled in the study protocol. Low initial serum sodium concentration and prolonged depression in serum sodium despite fluid restriction correlated significantly (P<0.001 to 0.01) with the presence of neurologic sequelae of the disease. Inappropriate secretion of antidiuretic hormone as the cause of these electrolyte changes could be inferred by indirect measurement of serum and urine solute and volume data and was specifically documented in patients enrolled most recently, by specific radioimmunoassay of antidiuretic hormone.