The association between serum sodium level and tuberculous meningitis compared with viral and bacterial meningitis

Abstract We evaluated the association between hyponatremia and tuberculous meningitis (TBM) with the aim of providing additional information for differential diagnosis from other types of infectious meningitis, especially viral meningitis (VM). Cross-sectional and longitudinal data involving 5026 pa...

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Autores principales:	Seunghee Na, Taewon Kim, In-Uk Song, Sung-Woo Chung, Seong-Hoon Kim, Yoon-Sang Oh, Juhee Oh, Woojun Kim
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/20042ab943a849bdaa5d26cd2e6bbb9c
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spelling	oai:doaj.org-article:20042ab943a849bdaa5d26cd2e6bbb9c2021-12-02T16:53:01ZThe association between serum sodium level and tuberculous meningitis compared with viral and bacterial meningitis10.1038/s41598-021-90358-52045-2322https://doaj.org/article/20042ab943a849bdaa5d26cd2e6bbb9c2021-05-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-90358-5https://doaj.org/toc/2045-2322Abstract We evaluated the association between hyponatremia and tuberculous meningitis (TBM) with the aim of providing additional information for differential diagnosis from other types of infectious meningitis, especially viral meningitis (VM). Cross-sectional and longitudinal data involving 5026 participants older than 18 years were analyzed in the total population and a propensity-matched population. The initial and lowest sodium levels and longitudinal changes in TBM, bacterial meningitis (BM), and VM patients were compared. Participants in the TBM group were enrolled when they were diagnosed as possible, probable, or definite TBM according to the Marais’ criteria. The initial serum sodium level was significantly lower in TBM patients than in BM and VM patients (136.9 ± 5.9 vs. 138.3 ± 4.7 mmol/L, p < 0.001 for TBM vs. BM, and 139.0 ± 3.1, p < 0.001 for TBM vs. VM), and it decreased significantly more steeply to lower levels in both the TBM and BM patients compared with VM patients. The lowest serum sodium level was in the order of TBM < BM < VM patients, and the change was statistically significant in all subgroups (131.8 ± 6.4, 133.1 ± 5.1, 137.4 ± 3.7, respectively, p < 0.001). Participants with lower serum sodium level were more likely to have a diagnosis of TBM rather than VM, and this association was more pronounced for the lowest sodium level than the initial sodium level [OR 4.6 (95% CI 2.4–8.8, p < 0.001)]. These findings indicate that baseline and longitudinal evaluation of serum sodium level can provide information for differential diagnosis of TBM from BM or VM.Seunghee NaTaewon KimIn-Uk SongSung-Woo ChungSeong-Hoon KimYoon-Sang OhJuhee OhWoojun KimNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Seunghee Na Taewon Kim In-Uk Song Sung-Woo Chung Seong-Hoon Kim Yoon-Sang Oh Juhee Oh Woojun Kim The association between serum sodium level and tuberculous meningitis compared with viral and bacterial meningitis
description	Abstract We evaluated the association between hyponatremia and tuberculous meningitis (TBM) with the aim of providing additional information for differential diagnosis from other types of infectious meningitis, especially viral meningitis (VM). Cross-sectional and longitudinal data involving 5026 participants older than 18 years were analyzed in the total population and a propensity-matched population. The initial and lowest sodium levels and longitudinal changes in TBM, bacterial meningitis (BM), and VM patients were compared. Participants in the TBM group were enrolled when they were diagnosed as possible, probable, or definite TBM according to the Marais’ criteria. The initial serum sodium level was significantly lower in TBM patients than in BM and VM patients (136.9 ± 5.9 vs. 138.3 ± 4.7 mmol/L, p < 0.001 for TBM vs. BM, and 139.0 ± 3.1, p < 0.001 for TBM vs. VM), and it decreased significantly more steeply to lower levels in both the TBM and BM patients compared with VM patients. The lowest serum sodium level was in the order of TBM < BM < VM patients, and the change was statistically significant in all subgroups (131.8 ± 6.4, 133.1 ± 5.1, 137.4 ± 3.7, respectively, p < 0.001). Participants with lower serum sodium level were more likely to have a diagnosis of TBM rather than VM, and this association was more pronounced for the lowest sodium level than the initial sodium level [OR 4.6 (95% CI 2.4–8.8, p < 0.001)]. These findings indicate that baseline and longitudinal evaluation of serum sodium level can provide information for differential diagnosis of TBM from BM or VM.
format	article
author	Seunghee Na Taewon Kim In-Uk Song Sung-Woo Chung Seong-Hoon Kim Yoon-Sang Oh Juhee Oh Woojun Kim
author_facet	Seunghee Na Taewon Kim In-Uk Song Sung-Woo Chung Seong-Hoon Kim Yoon-Sang Oh Juhee Oh Woojun Kim
author_sort	Seunghee Na
title	The association between serum sodium level and tuberculous meningitis compared with viral and bacterial meningitis
title_short	The association between serum sodium level and tuberculous meningitis compared with viral and bacterial meningitis
title_full	The association between serum sodium level and tuberculous meningitis compared with viral and bacterial meningitis
title_fullStr	The association between serum sodium level and tuberculous meningitis compared with viral and bacterial meningitis
title_full_unstemmed	The association between serum sodium level and tuberculous meningitis compared with viral and bacterial meningitis
title_sort	association between serum sodium level and tuberculous meningitis compared with viral and bacterial meningitis
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/20042ab943a849bdaa5d26cd2e6bbb9c
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The association between serum sodium level and tuberculous meningitis compared with viral and bacterial meningitis

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