Fatima Sumaiyah, Pathak Ram
Internal Medicine, Marshfield Clinic Health System, Marshfield, USA.
Endocrinology, Marshfield Clinic Health System, Marshfield, USA.
Cureus. 2025 Feb 16;17(2):e79110. doi: 10.7759/cureus.79110. eCollection 2025 Feb.
This is a case of a 20-year-old male with history of craniopharyngioma status post resection in 2007, panhypopituitarism on hormonal replacement, and obstructive hydrocephalus status post ventriculoperitoneal (VP) shunt, who presented with recurrent episodes of hyponatremia requiring hospitalization. During the clinical course of the disease since 2007, the patient was on hormonal replacement with hydrocortisone for hypocortisolism and desmopressin for diabetes insipidus with recommendations for stress dose of steroids during episodes of illnesses. Treatment with desmopressin and adrenal insufficiency as well as non-compliance with stress dose steroids were the compounding factors, causing severe hyponatremia. This case illustrates the importance of close monitoring of sodium levels during treatment with desmopressin as well as optimum steroid replacement in managing recurrent severe hyponatremia.
这是一例20岁男性患者，有颅咽管瘤病史，于2007年接受切除手术，因垂体功能减退接受激素替代治疗，因梗阻性脑积水接受脑室腹腔（VP）分流术后，出现反复低钠血症发作需住院治疗。自2007年疾病临床病程以来，患者因皮质醇缺乏接受氢化可的松激素替代治疗，因尿崩症接受去氨加压素治疗，并建议在疾病发作期间给予应激剂量的类固醇。去氨加压素治疗、肾上腺功能不全以及未遵医嘱使用应激剂量类固醇是导致严重低钠血症的复合因素。该病例说明了在去氨加压素治疗期间密切监测钠水平以及在处理反复严重低钠血症时优化类固醇替代治疗的重要性。
