Endocrine Abstracts

Introduction: Hyponatremia is rarely reported as a delayed complication of transsphenoidal resection of pituitary adenoma. Severe hyponatraemia can cause potentially fatal conse-quences.

Material and methods: A 34 year old patient was admitted as an urgent case at the Clinic of Endocrinology, with symptoms and signs of Addisonian crisis (dizziness, headaches, nausea, vomiting, hypotension), with muscular weakness and muscle aches, tingling hands and confusion. It was a pa-tient diagnosed with acromegaly due to STH secreting macroadenoma, with onset of symptoms 10 days after transsphenoidal pituitary surgery for macroadenoma.

Results: The biochemical analyses showed se-vere hyponatremia (Na=116, 118, 122, 136 mmol/l). There were no hormonal dysfunctions de-tected in the pituitary–thyroid and pituitary–gonadal axis, values of STH were 1.6 ng/ml. Because of expressed slow mental process, disorientation and somnolence brain KT was made, showing reduction in the ventricular system, flattened gyri and loss of sulci suggesting cerebral oedema. The con-dition of the patient improved after the correction of hyponatremia with hydrocortisone therapy.

Conclusion: Postoperative hyponatremia after transsphenoidal surgery is more common than previously reported and may lead to fatal complications. Therefore, all patients should undergo serum electrolyte level monitoring regularly for at least 1 or 2 weeks after transsphenoidal surgery.