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Renal salt wasting as part of dysautonomia in Guillain–Barré syndrome
  1. T Lenhard,
  2. C Grimm,
  3. P A Ringleb
  1. Department of Neurology, University Hospital of Heidelberg, Heidelberg, Germany
  1. Correspondence to Dr Thorsten Lenhard, Department of Neurology, INF 400, D-69120 Heidelberg, Germany; thorsten.lenhard{at}


Cerebral salt-wasting syndrome and the syndrome of inappropriate antidiuresis (SIAD) are the most important causes of non-iatrogenic hyponatraemia that can significantly complicate various brain diseases. Salt wasting without an underlying CNS disease may have been disregarded so far by clinicians and has been described as renal salt-wasting (RSW) in patients as drug side effect (eg, cisplatin), in older people with various common diseases (eg, hip fracture, pulmonary infections) and other sporadic conditions. In Guillain–Barré Syndrome (GBS), however, hyponatraemia has been described mainly as SIAD. However, symptoms of hyponatraemia rarely develop in GBS. Here, we report on a woman with GBS with dominant symptoms of dysautonomia and moderate severe hyponatraemia. We could identify RSW as part of the autonomic dysfunction that significantly contributed to disease worsening.

  • Hyponatraemia
  • radiculopathy
  • respiratory insufficiency
  • intensive care

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  • Competing interests All authors declare that there are no competing interests.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.