A Misdiagnosed Case of Secondary Adrenal Insufficiency Due to Pituitary Macroadenoma as Syndrome of Inappropriate Secretion of Antidiuretic Hormone (SIADH)

Keimyung Medical Journal 2013;32(1):92-97.

항이뇨호르몬 분비이상증후군으로 오인한 뇌하수체 거대선종에 의한 이차성 부신피질 기능 저하증 1례

김한별; 이예연; 조난희; 한유진; 정혜진; 김상진; 이호영; 김상윤; 김미경; 김혜순

Abstract

Hyponatremia is caused by various conditions and diseases; so it needs a precise and careful assessment and appropriate management. We described a 57-year-old male with a hyponatremia; presenting with general weakness and weight loss. Thyroid function test and rapid adrenocorticotropic hormone (ACTH) stimulation test was normal; so we assessed him as a syndrome of inappropriate secretion of antidiuretic hormone (SIADH). But in imaging work up of pituitary gland reveals a non-functioning pituitary mass and we performed a insulin secretion stimulation test and we diagnosed a secondary adrenal insufficiency. Thus; we report misdiagnosed case of secondary adrenal insufficiency due to pituitary macroadenoma as syndrome of inappropriate secretion of antidiuretic hormone (SIADH).

Key Words: Hyponatremia, Pituitary macroadenoma, Secondary adrenal insufficiency