title: Initial and postoperative hyponatremia associated with pituitary adenoma: a case report.
abstract: This 67 year-old man experienced 3 episodes of symptomatic hyponatraemia. Radiological examination revealed a sellar lesion and the tumour was removed via the transsphenoidal route. Thereafter, he simultaneously developed intractable diabetes insipidus and serious hyponatraemia with persistent natriuresis. His level of atrial natriuretic peptide was not significantly elevated, however, his plasma aldosterone concentration was low. The oral administration of salt gradually improved his hyponatraemia as well as the coincident symptoms. By the administration of a mineralocorticoid, fludrocortisone acetate, we succeeded in maintaining his serum sodium level without salt replacement. We discuss the mechanism(s) and treatment of hyponatraemia associated with pituitary tumour.
authors.affiliation: Division of Neurosurgery, Minamata City General Hospital and Medical Center, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Yamashiro
authors.forename: I
authors.initials: I
authors.lastname: Fuwa
authors.forename: H
authors.initials: H
authors.lastname: Seto
authors.forename: Y
authors.initials: Y
authors.lastname: Ushio
mesh_terms: D000236:Adenoma / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D000368:Aged; D003919:Diabetes Insipidus / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D005438:Fludrocortisone / Q000008:administration & dosage / Q000031:analogs & derivatives; D006801:Humans; D007010:Hyponatremia / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D007177:Inappropriate ADH Syndrome / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D008297:Male; D009318:Natriuresis / Q000502:physiology; D010911:Pituitary Neoplasms / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage; D014882:Water-Electrolyte Balance / Q000187:drug effects / Q000502:physiology
chemical_list: D012462:Saline Solution, Hypertonic; D005438:Fludrocortisone; C034635:fludrocortisone acetate