Osmotic demyelination syndrome in a patient with Noonan syndrome and anterior hypopituitarism
| Autor: | Tzy Harn Chua, Wann Jia Loh |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
LH Anterior hypopituitarism Abdominal pain Pathology Hydrocortisone Endocrinology Diabetes and Metabolism Levothyroxine Hypopituitarism Gynaecomastia Urine osmolality lcsh:Diseases of the endocrine glands. Clinical endocrinology Cortisol 0302 clinical medicine FSH Valproic acid Noonan syndrome FT3 Testosterone FT4 Desmopressin Neck - short Singapore TSH IGF1 Hyponatraemia Headache Saline Microadenoma Nausea GH Sex hormone binding globulin Neurology 030220 oncology & carcinogenesis Anesthesia Blood pressure medicine.symptom Hypotension Haemoglobin Hyponatremia Asian - other medicine.drug MRI Adult medicine.medical_specialty Insomnia Vomiting Thyroxine (T4) 030209 endocrinology & metabolism Hypotonia Kyphoscoliosis Dizziness Chloride August X-ray 03 medical and health sciences Ears - low set Hypothyroidism Pituitary adenoma Seizures Fluid repletion Internal Medicine Aphasia Bone mineral density medicine Glucocorticoids lcsh:RC648-665 Triiodothyronine (T3) business.industry Hypogonadism Sodium nutritional and metabolic diseases Unique/Unexpected Symptoms or Presentations of a Disease medicine.disease Cortisol (serum) ACTH Short stature Glucose Pituitary 25-hydroxyvitamin-D3 Neck - loose skin (nape) Osteoporosis business Serum osmolality Cortisol (9am) |
| Zdroj: | Endocrinology, Diabetes & Metabolism Case Reports, Vol 1, Iss 1, Pp 1-6 (2020) Endocrinology, Diabetes & Metabolism Case Reports |
| ISSN: | 2052-0573 |
| Popis: | Summary Severe hyponatremia and osmotic demyelination syndrome (ODS) are opposite ends of a spectrum of emergency disorders related to sodium concentrations. Management of severe hyponatremia is challenging because of the difficulty in balancing the risk of overcorrection leading to ODS as well as under-correction causing cerebral oedema, particularly in a patient with chronic hypocortisolism and hypothyroidism. We report a case of a patient with Noonan syndrome and untreated anterior hypopituitarism who presented with symptomatic hyponatremia and developed transient ODS. Learning points: Patients with severe anterior hypopituitarism with severe hyponatremia are susceptible to the rapid rise of sodium level with a small amount of fluid and hydrocortisone. These patients with chronic anterior hypopituitarism are at high risk of developing ODS and therefore, care should be taken to avoid a rise of more than 4–6 mmol/L per day. Early recognition and rescue desmopressin and i.v. dextrose 5% fluids to reduce serum sodium concentration may be helpful in treating acute ODS. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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