Hyponatremia and syndrome of inappropriate antidiuretic hormone secretion in Kawasaki disease

Goh Woon Lim, Mina Lee, Hae Soon Kim, Young Mi Hong, Sejung Sohn

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39 Scopus citations


Background and Objectives: The pathogenesis of hyponatremia (serum sodium <135 mEq/L) in Kawasaki disease (KD) remains unclear. We investigated the clinical significance of hyponatremia, and the role of interleukin (IL)-6 and IL-Iβ in the development of hyponatremia and syndrome of inappropriate antidiuretic hormone secretion (SIADH) in KD. Subjects and Methods: Fifty KD patients were prospectively enrolled and analyzed for clinical and laboratory variables according to the presence of hyponatremia or SIADH. Results: Thirteen KD patients (26%) had hyponatremia and 6 of these had SIADH. In patients with hyponatremia, the percentage of neutrophils (% neutrophils), C-reactive protein (CRP), and N-terminal pro-brain natriuretic peptide (NT-proBNP) were higher than in those without hyponatremia, while serum triiodothyronine (T3) and albumin were lower. Patients with hyponatremia had a higher incidence of intravenous immunoglobulin-resistance but this was not statistically significant. No differences existed between patients with and without SIADH with regard to clinical or laboratory variables and the incidence of IVIG-resistance. Serum sodium inversely correlated with % neutrophils, CRP, and NT-proBNP, and positively correlated with T3 and albumin. Serum IL-6 and IL-1β levels increased in KD patients and were higher in patients with hyponatremia. Plasma antidiuretic hormone increased in patients with SIADH, which tended to positively correlate with IL-6 and IL-1β levels. Conclusion: Hyponatremia occurs in KD patients with severe inflammation, while increased IL-6 and IL-1β may activate ADH secretion, leading to SIADH and hyponatremia in KD.

Original languageEnglish
Pages (from-to)507-513
Number of pages7
JournalKorean Circulation Journal
Issue number10
StatePublished - Oct 2010


  • Hyponatremia
  • Inappropriate antidiuretic hormone syndrome
  • Interleukins
  • Kawasaki disease


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