Clinical Edge

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Hyponatremia Secondary to AD in Early Infancy

Hyponatremia secondary to severe atopic dermatitis (AD) is age-dependent manifestation, caused by inappropriate treatment which leads to sodium loss from damaged skin and resultant hyperkalemia via multifaceted mechanisms. This according to a study that examined hyponatremia as secondary to severe AD in early infancy. Researchers found:

  • 36 patients <9 months of age were included in the analysis.
  • 28 patients had hyperkalemia, 7 showed normokalema.
  • Nutrition was mainly with breastfeeding; parental refusal of steroid ointment and the association of hypoalbuminemia were frequent findings.
  • Diminished urinary sodium level was verified in all 12 patients tested, including that sodium loss from the skin exudates, with limited supply of sodium from breast-milk, is the primary cause of hyponatremia.


Adachi M, Takamasu T, Inuo C. Hyponatremia secondary to severe atopic dermatitis in early infancy. [Published online ahead of print April 15, 2019]. Pediatr Int. doi:10.1111/ped.13865.