Soonchunhyang Med Sci.  2019 Jun;25(1):69-72. 10.0000/sms.2019.25.1.69.

A Case of Adipsic Hypernatremia in a Patient with Panhypopituitarism Treated with Growth Hormone Replacement

• Mhun EH
• Lee JH
• Lee DH

• KMID: 2452800
• DOI: http://doi.org/10.0000/sms.2019.25.1.69

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.

Keyword

Adipsic hypernatremia; Panhypopituitarism; Growth hormone replacement

MeSH Terms

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
Growth Hormone
Sodium
Vasopressins
Water