We describe the case of a term newborn who presented with hypernatremic dehydration
on day 19 of life. The baby was otherwise hemodynamically stable with no evidence
of focal or asymmetric neurological signs. The laboratory tests at the time of admission
were negative except for hypernatremia and the extremely elevated levels of cerebrospinal
fluid (CSF) protein (717 mg/dL) and glucose levels (97 mg/dL). The hypernatremic dehydration
was corrected as per the unit protocol over 48 hours. Repeat CSF analysis done after
5 days showed normalization of the protein and glucose levels. Serial follow-up and
neuroimaging showed no evidence of neurological sequelae. Unique feature of our case
is this is the first case reporting such an extreme elevation of CSF protein and glucose
levels that have had no bearing on neurodevelopmental outcome at 1 month and 3 months
of follow-up.
Keywords
hypernatremia - cerebrospinal fluid - extreme elevation
