Adrenal Insufficiency and Inappropriate Secretion of Antidiuretic Hormone

A case of Hyponatremia in Panhypopituitarism Caused by the Primary Empty Sella Syndrome

“…Hypoosmolar syndrome with impaired water diuresis by the kidney is sometimes associated in patients with primary or secondary adrenal insufficiency (Bethune and Nelson, 1965;Schambelan et al, 1969;Agus and Goldberg, 1971), which is quickly improved by glucocorticoid replacement (Oleesky, 1953), Hypoosmolar syndrome is also observed in hypothyroid patients (Goldberg and Reivich, 1962;Pettinger et al, 1965). The glucocorticoid replacement normalized her serum Na concentration before levothyroxine replacement.…”

Para-Endocrine Tumor Activity with Emphasis on Ectopic ADH Secretion

“…The cardinal findings in SIADH are: (1) hyponatremia with corresponding hypoosmolality of serum and extra cellular fluid; (2) continued sodium excretion despite hyponatremia (hyper tonic urine); (3) increase in hypoosmolar extracellular fluid volume; (4) inability to excrete a water load normally; (5) absence of adenohypophysial, cardiac, hepatic, adrenocortical, or renal insufficiency, and (6) correction of hyponatremia by rigorous water restriction. Hormone-active malignancies may metastasize into pituitary or adrenal cortex, causing insufficient endocrine function and possibly hyponatremia; ectopic ADH secretion by the tumor tissue, however, is responsible for development of the typical features of SIADH [29,85].…”