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The syndrome of inappropriate antidiuretic hormone (SIADH) and cerebral salt wasting (CSW) are two well-defined entities associated with hyponatremia in patients with intracranial disease. CSW is defined as renal loss of sodium due to intracranial diseases leading to hyponatremia, excessive natriuresis and volume depletion, which responds to volume and salt replacement.1 Similar phenomenon has also been reported in patients without underlying central nervous system (CNS) disease, which has been termed as renal salt wasting (RSW).2 Autonomic dysfunction is common in Guillain-Barré syndrome (GBS) especially in those needing mechanical ventilation. There is only few case reports of RSW in GBS.3 4 Presence of RSW in GBS may adversely affect in cardiovascular stability and outcome. It is therefore important to recognise this clinical entity and manage appropriately. We report six GBS patients with RSW, and describe their clinical and neurophysiological characteristics and outcome.
Six GBS patients with RSW were included prospectively. GBS was diagnosed based on clinical, cerebrospinal fluid and neurophysiological criteria. Both admission and peak disability was noted using a 0–10 Clinical Grading Scale (CGS). Autonomic dysfunction was defined by the presence of any of the following: sinus arrhythmia, resting tachycardia (heart rate >125/ min) or bradycardia (<48/min), …
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