EJMCR |

Case Report

Volume: 3 | Issue: 1 | Published: Jan 01, 1970 | Pages: 24 - 27 | DOI: 10.24911/ejmcr/173-1538418865

Severe hyponatremia as a presenting sign of panhypopituitarism due to non-functioning pituitary adenoma: a case report

Authors: Faryal Mehmood , Anum Ashfaq , Muhammad Atif Beg

Article Info

Authors

Faryal Mehmood

Pakistan Atomic Energy Commission General Hospital, Islamabad, Pakistan

Anum Ashfaq

Pakistan Atomic Energy Commission General Hospital, Islamabad, Pakistan

Muhammad Atif Beg

Pakistan Atomic Energy Commission General Hospital, Islamabad, Pakistan

Publication History

Received: October 24, 2018

Revised: November 16, 2018

Accepted: December 04, 2018

Published: January 01, 1970

Abstract

ABSTRACT BACKGROUND: Hyponatremia is a commonest electrolyte imbalance which is defined as "serum sodium level less than 135mEq/L". It is seen especially in elderly patients presenting in emergency department of hospitals. There are wide range of differentials in hyponatremic patients but it can be the initial sign of pituitary disease specifically in old age population. Diagnosis can often be challenging because symptoms can be attributed to normal aging process and high index of clinical suspicion is necessary. CASE PRESENTATION: Here we present the case of 61-year old female presented in our facility with history of vomiting, drowsiness and fatigue for 2 days before admission. On investigating, her CBC, LFT's, RFT's and urine R/E were within normal limits. Serum electrolytes showed hyponatremia. CXR was also normal. As patient was not in fluid overload, so our differentials based on euvolumic hyponatremia included syndrome of inappropriate anti-diuretic hormone secretion(SIADH), severe hypothyroidism or glucocorticoid insufficiency. Urine osmolarity was not in range of SIADH. Serum cortisol was normal. FSH, LH, estrogen and progesterone were low although these should be high as patient was post-menopausal. Prolactin was normal. MRI brain with contrast showed supra and intrasellar mass consistent with pituitary macroadenoma. Depending on presentation and investigations, Non-functioning pituitary adenoma(NFPA) presenting with panhypopituitarism complicated by hyponatremia was the final diagnosis. CONCLUSION: Our case highlights the importance of diagnosing NFPA in elderly patients who present with hyponatemia which can often be challenging and should not be delayed as this is life-saving, hence targeted treatment should be started as soon as possible.

Keywords: KEY WORDS: hyponatremia, non-functioning pituitary adenoma, macroadenoma , green

Pubmed Style

Faryal Mehmood, Anum Ashfaq, Muhammad Atif Beg. Severe hyponatremia as a presenting sign of panhypopituitarism due to non-functioning pituitary adenoma: a case report. EJMCR. 1970; 01 (January 1970): 24-27. doi:10.24911/ejmcr/173-1538418865

Web Style

Faryal Mehmood, Anum Ashfaq, Muhammad Atif Beg. Severe hyponatremia as a presenting sign of panhypopituitarism due to non-functioning pituitary adenoma: a case report. https://ejmcr.com/articles/1500 [Access: December 04, 2024]. doi:10.24911/ejmcr/173-1538418865

AMA (American Medical Association) Style

Vancouver/ICMJE Style

Faryal Mehmood, Anum Ashfaq, Muhammad Atif Beg. Severe hyponatremia as a presenting sign of panhypopituitarism due to non-functioning pituitary adenoma: a case report. EJMCR. (1970), [cited December 04, 2024]; 01 (January 1970): 24-27. doi:10.24911/ejmcr/173-1538418865

Harvard Style

Faryal Mehmood, Anum Ashfaq, Muhammad Atif Beg (1970) Severe hyponatremia as a presenting sign of panhypopituitarism due to non-functioning pituitary adenoma: a case report. EJMCR, 01 (January 1970): 24-27. doi:10.24911/ejmcr/173-1538418865

Chicago Style

Faryal Mehmood, Anum Ashfaq, Muhammad Atif Beg. "Severe hyponatremia as a presenting sign of panhypopituitarism due to non-functioning pituitary adenoma: a case report." 01 (1970), 24-27. doi:10.24911/ejmcr/173-1538418865

MLA (The Modern Language Association) Style

Faryal Mehmood, Anum Ashfaq, Muhammad Atif Beg. "Severe hyponatremia as a presenting sign of panhypopituitarism due to non-functioning pituitary adenoma: a case report." 01.January 1970 (1970), 24-27. Print. doi:10.24911/ejmcr/173-1538418865

APA (American Psychological Association) Style

Faryal Mehmood, Anum Ashfaq, Muhammad Atif Beg (1970) Severe hyponatremia as a presenting sign of panhypopituitarism due to non-functioning pituitary adenoma: a case report. , 01 (January 1970), 24-27. doi:10.24911/ejmcr/173-1538418865