Catastrophic electrolyte imbalance caused by excessive production and overdrainage of cerebrospinal fluid in an infant with choroid plexus papilloma

Abstract

Choroid plexus papilloma (CPP), a neoplasm of choroid plexus in the cerebral ventricles, is usually accompanied by hydrocephalus. Obstruction of cerebrospinal fluid (CSF) pathways by the neoplasm may contribute to the development of hydrocephalus, but overproduction of CSF from the tumor is also a major factor in its development [1, 2]. In fact, overproduction of CSF is a unique phenomenon of tumors and of choroid plexus hyperplasia [3]. The chemical and osmotic composition of CSF is different from that of plasma. The sodium content of CSF is nearly identical to that of plasma, but the level of potassium in CSF is less than the level in plasma [4]. Infusions of hypotonic saline with physiologic potassium supplements are commonly used to maintain volume and electrolyte homeostasis in infants and children. If overlooked, this common practice can lead to a severe electrolyte imbalance in patients with CPP when excessive CSF is drained for a short period. Case report