Secondary adrenal insufficiency presenting as hyponatremia Report of one case

作者：Aizman Andres; Larrain Soledad; Rojas Luis

来源：Revista Medica de Chile, 2010, 138(9): 1144-1147.

• Adrenal insufficiency
• Hyponatremia
• Pituitary neoplasms

Hyponatremia can be a marker of an underlying disease We report a 52 years old male with Diabetes Mellitus who consulted for an episode of nausea and vomiting lasting four days His baseline serum sodium was 118 mEq/L He had no neurological deficit Hyponatremia was initially interpreted in context of gastrointestinal fluid loss but correction with saline solution was poor His urine sodium was 105 mEq/L and his urine osmolality was 281 mOsm/L so an Inappropriate Secretion of Antidiuretic Hormone Syndrome was suspected Later we found that the patient had a two year history of fatigue weakness anorexia frequent nausea vomiting and diarrhea loss of libido and decreased axillary and pubic hair Thyroid Stimulating Hormone (TSII) was normal and serum Cortisol < 1 mu g/dL A CT scan showed a sellar mass compatible with a macroadenoma There was also a moderately high serum prolactin and low testosterone thyroxin and growth hormone levels The visual field examination showed right temporal hemianopsia The patient was treated with steroids with a very good clinical response and serum sodium normalization Subsequently a transsphenoidal excision of the tumor was performed and replacement oldie other hot manes was started Now the patient remains asymptomatic (Rev Med Chile 2010 138 1144 1147)

• 出版日期2010-9