Arginine vasopressin secretion in Kenyan children with severe malaria

Hyponatraemia is common in African children with severe malaria, but the ca use is unknown, We measured plasma sodium (p[Na]) and arginine vasopressin concentrations (p[AVP]) in 30 consecutive children with severe malaria (19 had cerebral malaria), on admission, at 48 and 96h after admission. Hyponat raemia (p[Na] <130 mmol/l) occurred in 53 per cent of the children and was unrelated to peripheral parasite density, dehydration or abnormal renal fun ction. The highest p[AVP] were seen in patients with cerebral malaria. Over all, p[AVP] declined 96 h after treatment. In children with hyponatraemia ( cerebral and non-cerebral), p[AVP] levels were not suppressed and in 67 per cent of cases they were deemed inappropriate. Inappropriate AVP secretion is common in children with severe malaria and may influence fluid therapy a fter correction of initial dehydration.