A Case of Severe Hyponatremia Secondary to Pituitary Macroadenoma with Covid-19 Infection, Endocrinological Responses

Abstract

SARS-CoV-2 disease (COVID-19) has dramatically increased since March 2020. There is insufficient data to establish the risk of acquiring the hyponatremia in patient with COVID-19 infection. We report here the clinical features and therapeutic course of the severe hyponatremia secondary to pituitary macroadenoma with confirmed COVID-19 pneumonia. This is a 59-year-old man without renal disease, who developed severe hyponatremia, hardly explained by the emetic episode and/or diuretic treatment with thiazides. We know that hyponatremia occurs in patients with hypopituitarism, but infrequently as first presenting feature of a pituitary tumor in the context of a respiratory infection by COVID-19, which has probably exacerbated its presentation. We conclude, that in our case, in addition to the finding of a non-functioning pituitary macroadenoma that determines a cortisol deficiency, we consider that COVID-19 infection could have played a role in the severity of the symptoms of hyponatremia.