Hyponatremia in Patients with Tuberculous Meningitis: A Clinical Overview

Authors

  • Muhammad Ishfaq Hayatabad Medical Complex, Peshawar
  • Husnain Ahmed Hayatabad Medical Complex, Peshawar
  • Alvina Ahmed Hayatabad Medical Complex, Peshawar
  • Filza Ajmal Hayatabad Medical Complex, Peshawar
  • Iman Aly Hayatabad Medical Complex, Peshawar
  • Afsheen Mehmood Khyber Girls Medical College, Peshawar, HMC

DOI:

https://doi.org/10.37762/jgmds.12-3.693

Keywords:

Hyponatremia, Tuberculous meningitis, Tertiary Care hospital, Central Nervous System

Abstract

OBJECTIVES

This study aims to determine the frequency of hyponatraemia in patients suffering from tuberculous meningitis in a tertiary care hospital.

METHODOLOGY

A cross-sectional study was conducted from January to June 2024 at the Department of Medicine, Hayatabad Medical Complex, Peshawar. We conducted this study on 219 patients. Presenting with tuberculous meningitis, having an age between 18 to 60 years of either gender. Patients with bipolar affective disorder, posttraumatic stress, lung carcinoma, hypothyroidism, or hyperthyroidism and pregnant women were excluded. The frequency of hyponatraemia was determined.

RESULTS
This study was conducted on 219 patients presenting with tuberculous meningitis. The mean age of the study patients was 42.41 ± 11.38 years. The frequency of hyponatremia in our study was 75 (34.2%). Stratification of hyponatremia with age, gender, diabetes, hypertension and duration of disease was not significant with a p-value> 0.05.

CONCLUSION

Hyponatremia is a fairly common occurrence in Tuberculous meningitis patients, and its early detection and management are crucial to patient management.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Author Biographies

Muhammad Ishfaq, Hayatabad Medical Complex, Peshawar

Associate Professor, Department of Medicine,
Hayatabad Medical Complex, Peshawar

Husnain Ahmed, Hayatabad Medical Complex, Peshawar

Postgraduate Trainee, Department of Medicine,
Hayatabad Medical Complex, Peshawar

Alvina Ahmed, Hayatabad Medical Complex, Peshawar

Postgraduate Trainee, Department of Medicine,
Hayatabad Medical Complex, Peshawar

Filza Ajmal, Hayatabad Medical Complex, Peshawar

Postgraduate Trainee, Department of Medicine,
Hayatabad Medical Complex, Peshawar

Iman Aly, Hayatabad Medical Complex, Peshawar

Postgraduate Trainee,
Department of Medicine,
Hayatabad Medical Complex, Peshawar

Afsheen Mehmood, Khyber Girls Medical College, Peshawar, HMC

Associate Professor,
Khyber Girls Medical College, Peshawar, HMC 

References

Na S, Kim T, Song I-U, Chung S-W, Kim S-H, Oh Y-S, et al. The association between serum sodium level and tuberculous meningitis compared with viral and bacterial meningitis. Sci Rep. 2021;11(1):10906-. https://doi.org/10.1038/s41598-021-90358-5. PubMed PMID: 34035388. DOI: https://doi.org/10.1038/s41598-021-90358-5

Kamat AS, Gretschel A, Vlok AJ, Solomons R. CSF protein concentration associated with ventriculoperitoneal shunt obstruction in tuberculous meningitis. The International Journal of Tuberculosis and Lung Disease. 2018;22(7):788-92. https://doi.org/10.5588/ijtld.17.0008 DOI: https://doi.org/10.5588/ijtld.17.0008

Cao X, Yang Q, Zhou X, Lv K, Zhou Z, Sun F, et al. Cerebral Infarction and Evan's Ratio on MRI Affect the Severity and Prognosis of Tuberculosis Meningitis Patients. Diagnostics (Basel). 2022;12(5):1264. https://doi.org/10.3390/diagnostics12051264. PubMed PMID: 35626418 DOI: https://doi.org/10.3390/diagnostics12051264

Cui H, He G, Yang S, Lv Y, Jiang Z, Gang X, et al. Inappropriate Antidiuretic Hormone Secretion and Cerebral Salt-Wasting Syndromes in Neurological Patients. Front Neurosci. 2019;13:1170-. https://doi.org/10.3389/fnins.2019.01170. PubMed PMID: 31780881 DOI: https://doi.org/10.3389/fnins.2019.01170

Kubre J, Goyal V, Saigal S, Sharma JP, Joshi R. Tuberculous Meningitis Presenting as Cerebral Salt Wasting Syndrome. Neurology India. 2021;69(1):190-3. https://doi.org/10.4103/0028-3886.310074 DOI: https://doi.org/10.4103/0028-3886.310074

Misra UK, Kalita J, Tuberculous Meningitis International Research C. Mechanism, spectrum, consequences and management of hyponatremia in tuberculous meningitis. Wellcome Open Res. 2021;4:189-. https://doi.org/10.12688/wellcomeopenres.15502.2. PubMed PMID: 32734004 DOI: https://doi.org/10.12688/wellcomeopenres.15502.2

Kumar A, Singh J, Hashmat O, Ameet P, Budhrani N, Sher K. Frequency of Hyponatremia in Patients of Tuberculosis Bacterial Meningitis in a Tertiary Care Hospital. Cureus. 2021;13(3):e13888-e. https://doi.org/10.7759/cureus.13888. PubMed PMID: 33868852 DOI: https://doi.org/10.7759/cureus.13888

Dian S, Ardiansyah E, Chaidir L, van Laarhoven A, Ruslami R, Alisjahbana B, et al. Clinical Significance of Hyponatremia in Tuberculous Meningitis: A Prospective Cohort in Indonesia. Open Forum Infect Dis. 2024;11(12):ofae673-ofae. https://doi.org/10.1093/ofid/ofae673. PubMed PMID: 39660022 DOI: https://doi.org/10.1093/ofid/ofae673

Bal C, Gompelmann D, Krebs M, Antoniewicz L, Guttmann-Ducke C, Lehmann A, et al. Associations of hyponatremia and SIADH with increased mortality, young age and infection parameters in patients with tuberculosis. PLoS One. 2022;17(10):e0275827-e. https://doi.org/10.1371/journal.pone.0275827. PubMed PMID: 36227934 DOI: https://doi.org/10.1371/journal.pone.0275827

Hall M. CNS tuberculosis. Radiopaediaorg: Radiopaedia.org; 2015 DOI: https://doi.org/10.53347/rID-40083

Munakomi S, Grasso G, Chapagain R. Multi-spectral Pattern of Clinical Presentation and the Resultant Outcome in Central Nervous System Tuberculosis: A Single Center Study on the Ubiquitous Pathogen. Advances in Experimental Medicine and Biology: Springer International Publishing; 2020. p. 29-35 DOI: https://doi.org/10.1007/5584_2019_466

Zhu X, He N, Tong L, Gu ZH, Li H. Clinical characteristics of tuberculous meningitis in older patients compared with younger and middle-aged patients: a retrospective analysis. BMC Infect Dis. 2023;23(1):699-. https://doi.org/10.1186/s12879-023-08700-3. PubMed PMID: 37853321 DOI: https://doi.org/10.1186/s12879-023-08700-3

Vinnard C, Blumberg EA. Endocrine and Metabolic Aspects of Tuberculosis. Microbiol Spectr. 2017;5(1):10.1128/microbiolspec.tnmi7-0035-2016. https://doi.org/10.1128/microbiolspec.TNMI7-0035-2016. PubMed PMID: 28233510 DOI: https://doi.org/10.1128/microbiolspec.TNMI7-0035-2016

Wasay M, Khan M, Farooq S, Khowaja ZA, Bawa ZA, Mansoor Ali S, et al. Frequency and Impact of Cerebral Infarctions in Patients With Tuberculous Meningitis. Stroke. 2018;49(10):2288-93. https://doi.org/10.1161/strokeaha.118.021301 DOI: https://doi.org/10.1161/STROKEAHA.118.021301

Ahmad W, Jan N, Mahmud Aurangzeb J, Iltaf M. Hyponatremia In Liver Cirrhosis: A Retrospective Study At A Tertiary Care Hospital. Khyber Journal of Medical Sciences. 2025;17(4):344-8. https://doi.org/10.70520/kjms.v17i4.626 DOI: https://doi.org/10.70520/kjms.v17i4.626

Arshad M, Zeb S, Tauseef MA, Ullah N. Correlation of Serum Sodium with Severity of Hepatic Encephalopathy. Journal of Gandhara Medical and Dental Science. 2016;3(01):3-10. https://doi.org/10.37762/jgmds.3-01.41. DOI: https://doi.org/10.37762/jgmds.3-01.41

Zeb S, Abbas M, Khan KA. Correlation of Serum Sodium Level with Severity of Hepatic Encephalopathy. Pakistan Journal of Medical and Health Sciences. 2022;16(6):239-41. https://doi.org/10.53350/pjmhs22166239 DOI: https://doi.org/10.53350/pjmhs22166239

Misra UK, Kalita J. Mechanism, spectrum, consequences and management of hyponatremia in tuberculous meningitis [version 1; peer review: 2 approved]. 2019 DOI: https://doi.org/10.12688/wellcomeopenres.15502.1

Downloads

Published

2025-06-30

How to Cite

Ishfaq, M., Ahmed, H. ., Ahmed, A. ., Ajmal, F. ., Aly, I. ., & Mehmood, A. . (2025). Hyponatremia in Patients with Tuberculous Meningitis: A Clinical Overview. Journal of Gandhara Medical and Dental Science, 12(3), 50–53. https://doi.org/10.37762/jgmds.12-3.693