Tezcan Kaya, AHMET NALBANT, CEYHUN VARIM, EMRAH AKAY, Ali TAMER

Ciddi Hiponatreminin Nadir Bir Sebebi: Primer Empty Sella Sendromu

Hiponatremi nedenlerinden primer empty sella sendromuna bağlı panhipopituitarizm nadir görülen bir durumdur. Bu yazıda iştahsızlık, bulantı, kusma şikayetleriyle başvuran, ciddi hiponatremi nedeniyle yatırılan ve primer empty sella sendromuna bağlı panhipopituitarizm tanısı koyduğumuz 64 yaşındaki bir olguyu sunduk. Uygun replasman tedavileriyle olgunun şikayetleri ve hiponatremisi düzeldi. ileri yaşlarda spesifik olmayan belirti ve bulguları, hiponatremisi olan hastalarda ayırıcı tanıda primer empty sella sendromuna bağlı panhipopituitarizm de düşünülmelidir.

(A rare cause of severe hyponatremia: Primary empty sella syndrome)

Panhypopituitarism due to primary empty sella syndrome rarely cause hyponatremia. In this article, we present a case of 64 years old; was admitted with nausea, vomiting, anorexia; hospitalized because of severe hyponatremia and diagnosed as panhypopituitarism due to primary empty sella syndrome. Patients symptoms and hyponatremia were improved with appropriate replacement therapies. Panhypopituitarism due to primary empty sella syndrome should be considered in the differential diagnosis in patients with hyponatremia, have nonspecific signs and symptoms at advanced ages.

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1. Upadhyay A, Jaber BL, Madias NE: Incidence and prevalence of hyponatremia. Am J Med 2006;119 :30-5.
2. Hoorn EJ, Lindemans J, Zietse R. Development of severe hyponatraemia in hospitalized patients: Treatment-related risk factors and inadequate management. Nephrol Dial Transplant 2006;21:70-6.
3. P Del Monte, L Foppiani, C Cafferata, et al. Primary Empty Sella in Adults: Endocrine Findings. Endocrine Journal 2006;53:803-9.
4. Thompson C, Hoorn EJ. Hyponatraemia: an overview of frequency, clinical presentation and complications. Best Pract Res Clin Endocrinol Metab. 2012;26 Suppl 1:S1-6.
5. Yıldız G, Kayataş M, Candan F. Hiponatremi; Güncel Tanı ve Tedavisi, Rewiev. Turk Neph Dial Transpl 2011;20 :115-31.
6. De Marinis L, Bonadonna S, Bianchi A, Maira G, Giustina A. Primary empty sella. J Clin Endocrinol Metab 2005;90:5471-7.
7. McLachlan MS, Williams ED, Fortt RW, et al. Estimation of pituitary gland dimensions from radiographs of the sella turcica. A post mortem study. Br J Radiol 1968;41:323-30.
8. Komada H, Yamamoto M, Okubo S, et al. A Case of Hypothalamic Panhypopituitarism with Empty Sella Syndrome: Case Report and Review of the Literature. Endocrine Journal 2009;56:585-9.
9. Bjerre P. The empty sella A reappraisal of etiology and pathogenesis. Acta Neurol Scand 1990;(Supp 1)130:1-25.
10. Arai H. Empty sella syndrome. Nippon Rinsho. Review 2006;212-6.
11. Diederich S, Franzen NF, Bahr V, Oelkers W. Severe hyponatremia due to hypopituitarism with adrenal insufficiency: report on 28 cases. Eur J Endocrinol 2003;148:609-17.
12. Chanson P. Severe hyponatremia as a frequent revealing sign of hypopituitarism after 60 year of age. Eur J Endocrinol 2003;149:177-8.