Open AccessIsolated second-phase diabetes insipidus post-transsphenoidal surgery
Author(s) -
Annalisa Montebello,
Darryl Portelli,
Mark Gruppetta
Publication year - 2020
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2020-235499
Subject(s) - medicine , diabetes insipidus , hyponatremia , lethargy , fluid restriction , transsphenoidal surgery , nausea , pituitary adenoma , diabetes mellitus , surgery , endocrinology , anesthesia , adenoma
A 57-year-old woman presented with severe lethargy, dizziness and nausea 1 week after transsphenoidal resection of a growth hormone secreting pituitary adenoma. She was found to have severe hyponatremia of 115 mmol/L. Importantly, she was neurologically intact and clinically euvolaemic. Her fluid intake was restricted and her sodium levels increased to 131 mmol/L over 4 days. She made a full recovery.She was diagnosed with isolated second-phase diabetes insipidus, a state of symptomatic hypoosmolar hyponatremia that usually occurs 7-10 days after transsphenoidal surgery. The sodium levels improve with fluid restriction.