顽固性低钠血症伴垂体肿瘤--不适当抗利尿激素分泌综合征一例
Hyponatremia with pituitary tumor---One case of syndrome of inappropriate antidiuretic hormone secretion
57岁女性患者,因为垂体肿瘤手术后顽固性低钠血症入院评估,患者在应激剂量的糖皮质激素替代下,依旧存在明显的低钠血症。通过对患者血尿渗透压以及患者限制饮水后的各项临床指标的分析,发现患者限水500 ml/d后血钠与尿酸水平逐渐升高,血压逐渐下降至正常,即使停止氢化可的松替代治疗依旧可以维持正常血钠水平。提示患者诊断为不适当抗利尿激素分泌综合征。患者接受垂体手术以及放疗,最终患者血钠水平在没有限水的情况下维持于正常范围。
更多A 57-year-old female patient was admitted to our hospital because of sustained hyponatremia within stress dose of hydrocortisone replacement after transsphenoidal partial pituitary tumor surgery. Multiple clinical parameters investigation for 2 weeks was shown increasing serum Na+and uric acid level and decreasing blood pressure level under water restriction about 500 ml/d, and even without hydrocortisone replacement, the serum Na+ still maintain normal level. After surgeries and radiotherapy, the tumor was undetectable and serum Na+ level was within the normal range without any water restriction.
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