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VOLUME 57 , ISSUE 3 ( July-September, 2023 ) > List of Articles
Deepak Thakran, Yogesh Kumar, Amit S Nachankar
Keywords : Case report, Empty sella, Hyponatremia, Hypopituitarism
Citation Information : Thakran D, Kumar Y, Nachankar AS. Refractory Hyponatremia as an Initial Presentation of Panhypopituitarism with Partial Empty Sella. J Postgrad Med Edu Res 2023; 57 (3):137-139.
License: CC BY-NC 4.0
Published Online: 26-07-2023
Copyright Statement: Copyright © 2023; The Author(s).
Introduction: Hyponatremia of varying severity is a fairly common disorder of water homeostasis encountered in the practice of internal medicine and has a variety of etiologies. Here we present a case of refractory hyponatremia secondary to an uncommon endocrine disorder. Case description: Our patient, a 55-year-old woman with a known case of hypothyroidism for 5 years, presented with complaints of moderate, symptomatic, and persistent hyponatremia. An evaluation revealed chronic euvolemic hyponatremia refractory to 3% saline. Further workup to rule out the syndrome of inappropriate antidiuretic hormone (SIADH) revealed panhypopituitarism with partial empty sella (PES). Discussion: Though usually not associated with any hormonal deficiency, rarely PES is associated with a deficiency of one or more pituitary hormones. Equally rare is the syndrome of euvolemic hyponatremia secondary to empty sella syndrome with hypopituitarism. Panhypopituitarism can have life-threatening consequences if left undiagnosed and untreated. Conclusion: In any case of euvolemic hyponatremia, it is important to work up for hypopituitarism as a rare cause before ruling in SIADH.