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July 1970

Extreme Elevations of Cerebrospinal Fluid Protein: Association With Hypernatremic Dehydration

Author Affiliations

Bronx, NY
From the Saul R. Korey Department of Neurology, and the Bela Schick Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY.

Am J Dis Child. 1970;120(1):84-87. doi:10.1001/archpedi.1970.02100060118023

Elevation of cerebrospinal fluid protein is one of the hallmarks of hypernatremic dehydration in infants. In their initial report, Finberg and Harrison1 noted CSF protein concentrations greater than 50 mg/100 cc in nearly all infants having CSF examinations with serum sodium levels above 150 mEq/liter. Usually, however, the CSF protein levels are in the range of 50 to 100 mg/100 cc, and extreme elevations in the absence of associated neurologic illness are distinctly rare.

Recently, we have observed two infants with hypernatremia who had unusually high levels of CSF protein. It is the purpose of this report to show that such values are consistent with hypernatremic dehydration uncomplicated by serious neurologic diseases. It will also be shown that the protein elevation may be explained well by recent investigations on the origin of CSF protein and by the known neuropathology of hypernatremia.

Report of Cases  Case 1.—A 3-month-old boy