A Case of Adipsic Hypernatremia in a Patient with Panhypopituitarism Treated with Growth Hormone Replacement
- Author:
Eui Hyon MHUN
1
;
Jong Hyun LEE
;
Dong Hwan LEE
Author Information
1. Department of Pediatrics, Soonchunhyang University Seoul Hospital, Seoul, Korea.
- Publication Type:Case Report
- Keywords:
Adipsic hypernatremia;
Panhypopituitarism;
Growth hormone replacement
- MeSH:
Child;
Craniopharyngioma;
Drinking;
Emergency Service, Hospital;
Growth Hormone;
Gyeongsangbuk-do;
Humans;
Hypernatremia;
Leg;
Male;
Nausea;
Neurologic Manifestations;
Osmolar Concentration;
Osmotic Pressure;
Rare Diseases;
Seizures;
Seoul;
Sodium;
Thirst;
Tremor;
Vasopressins;
Vomiting;
Water
- From:Soonchunhyang Medical Science
2019;25(1):69-72
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Adipsic hypernatremia is a rare disease where patients do not feel thirst even in the increased serum osmotic pressure and results in electrolyte imbalance, severely increased osmotic pressure and neurologic symptoms like nausea, vomiting, and seizures. We report a 12-year-old male patient who had underwent a trans-sphenoidal surgery for craniopharyngioma newly diagnosed with adipsic hypernatremia after having growth hormone replacement for growth hormone deficiency. The patient visited emergency room complaining of generalized weakness, tremor in both legs, and poor oral intake including water after starting growth hormone replacement therapy. Laboratory test revealed serum sodium 168 mmol/L and serum osmolality 329 mOsm/kg, despite the patient didn't feel any thirst at all. We treated him with scheduled water intake of 2.5 L a day with intranasal vasopressin. He admitted to Soonchunhyang University Gumi Hospital and Soonchunhyang University Seoul Hospital for 4 times during the following 8 months and serum sodium level and osmolality was controlled by scheduled water intake combined with intranasal vasopressin treatment. It is still unclear whether growth hormone replacement worked as a trigger of hypernatremia.
