scholarly journals PES Syndrome Presenting as Severe Hyponatremia in an Asymptomatic Septuagenarian

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Rahul Pansare ◽  
Sangeetha Nanthabalan
Keyword(s):  
Brain Mri ◽  
Hormone Secretion ◽  
Empty Sella ◽  
Severe Hyponatremia ◽  
Case Presentation ◽  
Inappropriate Antidiuretic Hormone Secretion ◽  
Methodical Approach ◽  
The Face ◽  
Neuroradiological Finding ◽  
Primary Empty Sella

Background. Hyponatremia is commonly seen in hospitalized patients. In euvolemic individuals, syndrome of inappropriate antidiuretic hormone secretion (SIADH) is a common differential. However, before establishing a diagnosis of SIADH, it is imperative to evaluate for hypocortisolism and hypothyroidism. The finding of endocrine abnormalities determined to be of pituitary origin should prompt evaluation by brain MRI. Furthermore, primary empty sella (PES) is commonly seen as an incidental neuroradiological finding. However, PES in association with endocrine abnormalities is recognized as a separate entity called primary empty sella syndrome (PESS). Case Presentation. We report the case of a 71-year-old male sans neurological symptoms who presented to us with severe hyponatremia in whom we used a stepwise approach which led us to the diagnosis of PESS. This methodical approach was crucial for timely correction of the endocrine abnormalities which in turn rectified hyponatremia. Intriguingly, the presence of an ectopic pituitary which is a very rare entity and the sudden manifestation of his underlying endocrine deficiencies in the 8th decade of life make this clinical scenario highly unusual. Conclusion. Clinicians should be aware that absence of an orderly approach to workup presumed SIADH or an assumption of PES (instead of PESS) could both lead to serious consequences in the face of missed endocrine deficiencies.

scholarly journals Uncommon manifestations of a rare disease: a case of autoimmune GFAP astrocytopathy

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hong Di ◽  
Yue Yin ◽  
Ruxuan Chen ◽  
Yun Zhang ◽  
Jun Ni ◽  
...  
Keyword(s):  
Rare Disease ◽  
Hormone Secretion ◽  
White Matter Lesions ◽  
Signs And Symptoms ◽  
Careful Examination ◽  
Case Presentation ◽  
Inappropriate Antidiuretic Hormone Secretion ◽  
Contrast Enhanced ◽  
The Central Nervous System ◽  
Magnetic Resonance Imaging Mri

Abstract Background Manifestations of intractable hyponatremia and hypokalemia in autoimmune glial fibrillary acidic protein (GFAP) astrocytopathy have been rarely reported. Case presentation A 75-year-old male patient presented as the case of syndrome of inappropriate antidiuretic hormone secretion (SIADH) and intractable hypokalemia, showed fever, fatigue, and mental disorders. Signs and symptoms of meningoencephalitis, ataxia, and cognitive abnormalities. Magnetic resonance imaging (MRI) revealed multiple white matter lesions of the central nervous system. He had GFAP-IgG in the cerebrospinal fluid (CSF). After treatment with corticosteroids, his symptoms were alleviated gradually, and the level of electrolytes was normal. However, head contrast-enhanced MRI + susceptibility-weighted imaging (SWI) showed a wide afflicted region, and the serum GFAP-IgG turned positive. Considering the relapse of the disease, ha was treated with immunoglobulin and mycophenolate mofetil (MMF) to stabilize his condition. Conclusion This case showed a rare disease with uncommon manifestations, suggesting that careful examination and timely diagnosis are essential for disease management and satisfactory prognosis.

Severe Hyponatremia Due to Rosiglitazone use in an Elderly Woman with Diabetes Mellitus: A Rare Cause of Syndrome of Inappropriate Antidiuretic Hormone Secretion

2008 ◽  
Vol 14 (8) ◽  
pp. 1017-1019 ◽  
Author(s):  
Dilek Berker ◽  
Yusuf Aydin ◽  
Ayşe Arduç ◽  
İhsan Ustün ◽  
Bilal Ergün ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Antidiuretic Hormone ◽  
Elderly Woman ◽  
Hormone Secretion ◽  
Severe Hyponatremia ◽  
Inappropriate Antidiuretic Hormone Secretion ◽  
Antidiuretic Hormone Secretion

scholarly journals Cerebral salt wasting in a patient with myeloproliferative neoplasm

2019 ◽  
Author(s):  
Lea Orlik ◽  
Reto Venzin ◽  
Thomas Fehr ◽  
Karin Hohloch
Keyword(s):  
Hormone Secretion ◽  
Myeloproliferative Neoplasm ◽  
Visual Disturbance ◽  
Mental Condition ◽  
Microcirculatory Disturbance ◽  
Volume Depletion ◽  
Severe Hyponatremia ◽  
Cerebral Salt Wasting ◽  
Inappropriate Antidiuretic Hormone Secretion ◽  
Salt Wasting

Abstract Background: Cerebral salt wasting (CSW) is a rare metabolic disorder with severe hyponatremia and volume depletion usually caused by brain injury like trauma, cerebral lesion, tumor or a cerebral hematoma. The renal function is normal with excretion of very high amounts of sodium in the urine. Diagnosis is made by excluding other reasons for hyponatremia, mainly the syndrome of inappropriate antidiuretic hormone secretion (SIADH). Case report: A 60-year-old patient was admitted to the emergency room with pain in the upper abdomen and visual disturbance two weeks after knee replacement. The patient was confused with severe hematoma at the site of the knee endoprosthesis. Laboratory values showed massive thrombocytosis, leukocytosis, anemia, severe hyponatremia and no evidence of infection. CT scan of the abdomen was inconspicuous. Head MRI showed no ischemia or bleeding, but a mild microangiopathy. A myeloproliferative neoplasm (MPN) was suspected and confirmed by bone marrow biopsy. Cerebral salt wasting syndrome was identified as the cause of severe hyponatremia most likely provoked by cerebral microcirculatory disturbance. The hematoma at the operation site was interpreted as a result of a secondary von Willebrand syndrome (vWS) due to the myeloproliferative neoplasm with massive thrombocytosis. After starting cytoreductive therapy with hydroxycarbamide, thrombocytosis and blood sodium slowly improved along with normalization of his mental condition. Conclusion: To the best of our knowledge this is the first description of a patient with CSW most likely caused by a microcirculatory disturbance due to a massive thrombocytosis in the context of a myeloproliferative neoplasm.

scholarly journals Cerebral salt wasting in a patient with myeloproliferative neoplasm

2019 ◽  
Author(s):  
Lea Orlik ◽  
Reto Venzin ◽  
Thomas Fehr ◽  
Karin Hohloch
Keyword(s):  
Hormone Secretion ◽  
Myeloproliferative Neoplasm ◽  
Volume Depletion ◽  
Severe Hyponatremia ◽  
Cerebral Salt Wasting ◽  
Inappropriate Antidiuretic Hormone Secretion ◽  
Salt Wasting ◽  
Cerebral Hematoma ◽  
Very High ◽  
Rare Metabolic Disorder

Abstract Background Cerebral salt wasting (CSW) is a rare metabolic disorder with severe hyponatremia and volume depletion usually caused by brain injury like trauma, cerebral lesion, tumor or a cerebral hematoma. The renal function is normal with excretion of very high amounts of sodium in the urine. Diagnosis is made by excluding other reasons for hyponatremia, mainly the syndrome of inappropriate antidiuretic hormone secretion (SIADH).

scholarly journals Cerebral salt wasting in a patient with myeloproliferative neoplasm

2019 ◽  
Author(s):  
Lea Orlik ◽  
Reto Venzin ◽  
Thomas Fehr ◽  
Karin Hohloch
Keyword(s):  
Hormone Secretion ◽  
Myeloproliferative Neoplasm ◽  
Volume Depletion ◽  
Severe Hyponatremia ◽  
Cerebral Salt Wasting ◽  
Inappropriate Antidiuretic Hormone Secretion ◽  
Salt Wasting ◽  
Cerebral Hematoma ◽  
Very High ◽  
Rare Metabolic Disorder

Abstract Background Cerebral salt wasting (CSW) is a rare metabolic disorder with severe hyponatremia and volume depletion usually caused by brain injury like trauma, cerebral lesion, tumor or a cerebral hematoma. The renal function is normal with excretion of very high amounts of sodium in the urine. Diagnosis is made by excluding other reasons for hyponatremia, mainly the syndrome of inappropriate antidiuretic hormone secretion (SIADH).

scholarly journals Severe Hyponatremia due to Levofloxacin Treatment for Pseudomonas aeruginosa Community-Acquired Pneumonia in a Patient with Oropharyngeal Cancer

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Mihaela Mocan ◽  
Sorin Nicu Blaga
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Case Report ◽  
Rare Complication ◽  
Hormone Secretion ◽  
Community Acquired Pneumonia ◽  
Electrolyte Imbalance ◽  
Severe Hyponatremia ◽  
Inappropriate Antidiuretic Hormone Secretion ◽  
Antidiuretic Hormone Secretion ◽  
First Case

Hyponatremia (serum Na levels of <135 mEq/L) is the most common electrolyte imbalance encountered in clinical practice, affecting up to 15–28% of hospitalized patients. This case report refers to a middle-aged man with severe hyponatremia due to Syndrome of Inappropriate Antidiuretic Hormone Secretion related to four possible etiological factors: glossopharyngeal squamous cell carcinoma, cisplatin treatment, right basal pneumonia with Pseudomonas aeruginosa, and the treatment with Levofloxacin. This case report discusses a rare complication of common conditions and of a common treatment. To our knowledge this is the first case of hyponatremia related to Levofloxacin and the second related to fluoroquinolones.

Syndrome of Inappropriate Antidiuretic Hormone Secretion and Severe Hyponatremia Due to Pioglitazone

2010 ◽  
Vol 20 (6) ◽  
pp. 277-278 ◽  
Author(s):  
Aydin Unal ◽  
Ismail Kocyigit ◽  
Murat Hayri Sipahioglu ◽  
Bulent Tokgoz ◽  
Oktay Oymak ◽  
...  
Keyword(s):  
Antidiuretic Hormone ◽  
Hormone Secretion ◽  
Severe Hyponatremia ◽  
Inappropriate Antidiuretic Hormone Secretion ◽  
Antidiuretic Hormone Secretion

scholarly journals Urinary Retention and Severe Hyponatremia: An Unusual Presentation of COVID-19

2020 ◽  
Author(s):  
Ahmed Osman Saleh ◽  
Shaikha D. Al-Shokri ◽  
Ashraf Ahmed ◽  
Ahmed Elmustafa Musa ◽  
Mouhand FH Mohamed
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Urinary Retention ◽  
Antidiuretic Hormone ◽  
Hormone Secretion ◽  
Unusual Presentation ◽  
Respiratory Syndrome Virus ◽  
Unique Case ◽  
Severe Hyponatremia ◽  
Inappropriate Antidiuretic Hormone Secretion ◽  
Antidiuretic Hormone Secretion

Coronavirus disease 2019 (COVID-19) was first reported in Wuhan, China, in December 2019. The disease is caused by severe acute respiratory syndrome virus coronavirus 2 (SARS-CoV-2). A few published cases have linked COVID-19 and hyponatremia. The mechanism of hyponatremia in these cases is related to the syndrome of inappropriate antidiuretic hormone secretion (SIADH). Here we present a unique case of urinary retention and SIADH as unusual presenting features of SARS-CoV-2 infection.

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