Enfrentamiento de la hiponatremia: Más allá de la corrección del sodio. A propósito de un caso clínico

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 contex...

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Autores principales:	AIZMAN,ANDRÉS, LARRAÍN,SOLEDAD, ROJAS,LUIS
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2010
Materias:	Adrenal insufficiency Hyponatremia Pituitary neoplasms
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872010000900010
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spelling	oai:scielo:S0034-988720100009000102010-11-09Enfrentamiento de la hiponatremia: Más allá de la corrección del sodio. A propósito de un caso clínicoAIZMAN,ANDRÉSLARRAÍN,SOLEDADROJAS,LUIS 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 (TSH) was normal and serum Cortisol < 1 µg/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 fi eld exami-nation 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 of the other hormones was started. Now the patient remains asymptomatic.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.138 n.9 20102010-09-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872010000900010es10.4067/S0034-98872010000900010
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Adrenal insufficiency Hyponatremia Pituitary neoplasms
spellingShingle	Adrenal insufficiency Hyponatremia Pituitary neoplasms AIZMAN,ANDRÉS LARRAÍN,SOLEDAD ROJAS,LUIS Enfrentamiento de la hiponatremia: Más allá de la corrección del sodio. A propósito de un caso clínico
description	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 (TSH) was normal and serum Cortisol < 1 µg/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 fi eld exami-nation 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 of the other hormones was started. Now the patient remains asymptomatic.
author	AIZMAN,ANDRÉS LARRAÍN,SOLEDAD ROJAS,LUIS
author_facet	AIZMAN,ANDRÉS LARRAÍN,SOLEDAD ROJAS,LUIS
author_sort	AIZMAN,ANDRÉS
title	Enfrentamiento de la hiponatremia: Más allá de la corrección del sodio. A propósito de un caso clínico
title_short	Enfrentamiento de la hiponatremia: Más allá de la corrección del sodio. A propósito de un caso clínico
title_full	Enfrentamiento de la hiponatremia: Más allá de la corrección del sodio. A propósito de un caso clínico
title_fullStr	Enfrentamiento de la hiponatremia: Más allá de la corrección del sodio. A propósito de un caso clínico
title_full_unstemmed	Enfrentamiento de la hiponatremia: Más allá de la corrección del sodio. A propósito de un caso clínico
title_sort	enfrentamiento de la hiponatremia: más allá de la corrección del sodio. a propósito de un caso clínico
publisher	Sociedad Médica de Santiago
publishDate	2010
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872010000900010
work_keys_str_mv	AT aizmanandres enfrentamientodelahiponatremiamasalladelacorrecciondelsodioapropositodeuncasoclinico AT larrainsoledad enfrentamientodelahiponatremiamasalladelacorrecciondelsodioapropositodeuncasoclinico AT rojasluis enfrentamientodelahiponatremiamasalladelacorrecciondelsodioapropositodeuncasoclinico
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Enfrentamiento de la hiponatremia: Más allá de la corrección del sodio. A propósito de un caso clínico

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