Pituitary macroadenoma presenting as severe hyponatremia: a case report View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2019-12

AUTHORS

Bopeththe Vidanelage Kameera Madhusanka Bopeththa, S. M. M. Niyaz, Chathuranga Medagedara

ABSTRACT

BACKGROUND: Hyponatremia is defined as a serum sodium level of less than 135 mEq/L in a patient. Although hyponatremia is not an uncommon laboratory finding, especially in the elderly, hunting for the etiology is a challenging issue for any clinician. The three first-line investigations that are required for further analysis are urine osmolality, serum osmolality, and urinary sodium levels in addition to clinical assessment of volume status. CASE PRESENTATION: A 69-year-old previously well Sinhalese man presented with lethargy, loss of appetite, vomiting, and altered behavior of 1 week's duration. An examination revealed Glasgow Coma Scale of 13/15 and marginally low blood pressure. Initial serum sodium level was 104 mmol/L, and plasma and urinary osmolalities were 251 mOsm/kg and 305 mOsm/kg, respectively. His urinary sodium level of 158 mmol/L was suggestive of a clinical picture of a syndrome of inappropriate secretion of antidiuretic hormone. Even after correction of hyponatremia with intravenously administered 3% saline, a persistent altered behavior necessitated cerebral imaging that confirmed the presence of pituitary macroadenoma. Meanwhile, his hormone profile showed very low serum cortisol and low free tetraiodothyronine levels. An ultrasound scan of his abdomen affirmed the presence of normal adrenal glands. With intravenously administered hydrocortisone and orally administered levothyroxine replacement, he showed marked clinical improvement that supported the diagnosis of hypopituitarism. CONCLUSION: Hyponatremia in the elderly is not an uncommon presentation. However, etiological diagnosis is a challenging task as there are multiple overlapping differential diagnoses. More... »

PAGES

40

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s13256-019-2000-4

DOI

http://dx.doi.org/10.1186/s13256-019-2000-4

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1112315672

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30795800


Indexing Status Check whether this publication has been indexed by Scopus and Web Of Science using the SN Indexing Status Tool
Incoming Citations Browse incoming citations for this publication using opencitations.net

JSON-LD is the canonical representation for SciGraph data.

TIP: You can open this SciGraph record using an external JSON-LD service: JSON-LD Playground Google SDTT

[
  {
    "@context": "https://springernature.github.io/scigraph/jsonld/sgcontext.json", 
    "about": [
      {
        "id": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/1103", 
        "inDefinedTermSet": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/", 
        "name": "Clinical Sciences", 
        "type": "DefinedTerm"
      }, 
      {
        "id": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/11", 
        "inDefinedTermSet": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/", 
        "name": "Medical and Health Sciences", 
        "type": "DefinedTerm"
      }
    ], 
    "author": [
      {
        "affiliation": {
          "alternateName": "Teaching Hospital Kandy", 
          "id": "https://www.grid.ac/institutes/grid.416931.8", 
          "name": [
            "Emergency Medicine, Teaching Hospital, kandy, 70500, Kandy, Sri Lanka"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Bopeththa", 
        "givenName": "Bopeththe Vidanelage Kameera Madhusanka", 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "alternateName": "Teaching Hospital Kandy", 
          "id": "https://www.grid.ac/institutes/grid.416931.8", 
          "name": [
            "Department of Surgery, Teaching Hospital, Kandy, Sri Lanka"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Niyaz", 
        "givenName": "S. M. M.", 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "alternateName": "Teaching Hospital Kandy", 
          "id": "https://www.grid.ac/institutes/grid.416931.8", 
          "name": [
            "Department of Surgery, Teaching Hospital, Kandy, Sri Lanka"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Medagedara", 
        "givenName": "Chathuranga", 
        "type": "Person"
      }
    ], 
    "citation": [
      {
        "id": "sg:pub.10.1007/s40618-016-0487-8", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1023171086", 
          "https://doi.org/10.1007/s40618-016-0487-8"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1016/j.arr.2012.04.006", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1029642928"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.2215/cjn.04431007", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1035081257"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.3121/cmr.2007.762", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1036571817"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://app.dimensions.ai/details/publication/pub.1079063792", 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1016/j.jecr.2017.05.001", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1085612903"
        ], 
        "type": "CreativeWork"
      }
    ], 
    "datePublished": "2019-12", 
    "datePublishedReg": "2019-12-01", 
    "description": "BACKGROUND: Hyponatremia is defined as a serum sodium level of less than 135\u2009mEq/L in a patient. Although hyponatremia is not an uncommon laboratory finding, especially in the elderly, hunting for the etiology is a challenging issue for any clinician. The three first-line investigations that are required for further analysis are urine osmolality, serum osmolality, and urinary sodium levels in addition to clinical assessment of volume status.\nCASE PRESENTATION: A 69-year-old previously well Sinhalese man presented with lethargy, loss of appetite, vomiting, and altered behavior of 1 week's duration. An examination revealed Glasgow Coma Scale of 13/15 and marginally low blood pressure. Initial serum sodium level was 104\u2009mmol/L, and plasma and urinary osmolalities were 251\u2009mOsm/kg and 305\u2009mOsm/kg, respectively. His urinary sodium level of 158\u2009mmol/L was suggestive of a clinical picture of a syndrome of inappropriate secretion of antidiuretic hormone. Even after correction of hyponatremia with intravenously administered 3% saline, a persistent altered behavior necessitated cerebral imaging that confirmed the presence of pituitary macroadenoma. Meanwhile, his hormone profile showed very low serum cortisol and low free tetraiodothyronine levels. An ultrasound scan of his abdomen affirmed the presence of normal adrenal glands. With intravenously administered hydrocortisone and orally administered levothyroxine replacement, he showed marked clinical improvement that supported the diagnosis of hypopituitarism.\nCONCLUSION: Hyponatremia in the elderly is not an uncommon presentation. However, etiological diagnosis is a challenging task as there are multiple overlapping differential diagnoses.", 
    "genre": "research_article", 
    "id": "sg:pub.10.1186/s13256-019-2000-4", 
    "inLanguage": [
      "en"
    ], 
    "isAccessibleForFree": true, 
    "isPartOf": [
      {
        "id": "sg:journal.1038062", 
        "issn": [
          "1752-1947"
        ], 
        "name": "Journal of Medical Case Reports", 
        "type": "Periodical"
      }, 
      {
        "issueNumber": "1", 
        "type": "PublicationIssue"
      }, 
      {
        "type": "PublicationVolume", 
        "volumeNumber": "13"
      }
    ], 
    "name": "Pituitary macroadenoma presenting as severe hyponatremia: a case report", 
    "pagination": "40", 
    "productId": [
      {
        "name": "readcube_id", 
        "type": "PropertyValue", 
        "value": [
          "7c7355dcf03d51c745a24be127010bb0f68ce1b9deb29243cb67f09f28993c75"
        ]
      }, 
      {
        "name": "pubmed_id", 
        "type": "PropertyValue", 
        "value": [
          "30795800"
        ]
      }, 
      {
        "name": "nlm_unique_id", 
        "type": "PropertyValue", 
        "value": [
          "101293382"
        ]
      }, 
      {
        "name": "doi", 
        "type": "PropertyValue", 
        "value": [
          "10.1186/s13256-019-2000-4"
        ]
      }, 
      {
        "name": "dimensions_id", 
        "type": "PropertyValue", 
        "value": [
          "pub.1112315672"
        ]
      }
    ], 
    "sameAs": [
      "https://doi.org/10.1186/s13256-019-2000-4", 
      "https://app.dimensions.ai/details/publication/pub.1112315672"
    ], 
    "sdDataset": "articles", 
    "sdDatePublished": "2019-04-11T10:59", 
    "sdLicense": "https://scigraph.springernature.com/explorer/license/", 
    "sdPublisher": {
      "name": "Springer Nature - SN SciGraph project", 
      "type": "Organization"
    }, 
    "sdSource": "s3://com-uberresearch-data-dimensions-target-20181106-alternative/cleanup/v134/2549eaecd7973599484d7c17b260dba0a4ecb94b/merge/v9/a6c9fde33151104705d4d7ff012ea9563521a3ce/jats-lookup/v90/0000000352_0000000352/records_60335_00000004.jsonl", 
    "type": "ScholarlyArticle", 
    "url": "https://link.springer.com/10.1186%2Fs13256-019-2000-4"
  }
]
 

Download the RDF metadata as:  json-ld nt turtle xml License info

HOW TO GET THIS DATA PROGRAMMATICALLY:

JSON-LD is a popular format for linked data which is fully compatible with JSON.

curl -H 'Accept: application/ld+json' 'https://scigraph.springernature.com/pub.10.1186/s13256-019-2000-4'

N-Triples is a line-based linked data format ideal for batch operations.

curl -H 'Accept: application/n-triples' 'https://scigraph.springernature.com/pub.10.1186/s13256-019-2000-4'

Turtle is a human-readable linked data format.

curl -H 'Accept: text/turtle' 'https://scigraph.springernature.com/pub.10.1186/s13256-019-2000-4'

RDF/XML is a standard XML format for linked data.

curl -H 'Accept: application/rdf+xml' 'https://scigraph.springernature.com/pub.10.1186/s13256-019-2000-4'


 

This table displays all metadata directly associated to this object as RDF triples.

98 TRIPLES      21 PREDICATES      35 URIs      21 LITERALS      9 BLANK NODES

Subject Predicate Object
1 sg:pub.10.1186/s13256-019-2000-4 schema:about anzsrc-for:11
2 anzsrc-for:1103
3 schema:author Nfceb0d234b594264bbabff76b9476196
4 schema:citation sg:pub.10.1007/s40618-016-0487-8
5 https://app.dimensions.ai/details/publication/pub.1079063792
6 https://doi.org/10.1016/j.arr.2012.04.006
7 https://doi.org/10.1016/j.jecr.2017.05.001
8 https://doi.org/10.2215/cjn.04431007
9 https://doi.org/10.3121/cmr.2007.762
10 schema:datePublished 2019-12
11 schema:datePublishedReg 2019-12-01
12 schema:description BACKGROUND: Hyponatremia is defined as a serum sodium level of less than 135 mEq/L in a patient. Although hyponatremia is not an uncommon laboratory finding, especially in the elderly, hunting for the etiology is a challenging issue for any clinician. The three first-line investigations that are required for further analysis are urine osmolality, serum osmolality, and urinary sodium levels in addition to clinical assessment of volume status. CASE PRESENTATION: A 69-year-old previously well Sinhalese man presented with lethargy, loss of appetite, vomiting, and altered behavior of 1 week's duration. An examination revealed Glasgow Coma Scale of 13/15 and marginally low blood pressure. Initial serum sodium level was 104 mmol/L, and plasma and urinary osmolalities were 251 mOsm/kg and 305 mOsm/kg, respectively. His urinary sodium level of 158 mmol/L was suggestive of a clinical picture of a syndrome of inappropriate secretion of antidiuretic hormone. Even after correction of hyponatremia with intravenously administered 3% saline, a persistent altered behavior necessitated cerebral imaging that confirmed the presence of pituitary macroadenoma. Meanwhile, his hormone profile showed very low serum cortisol and low free tetraiodothyronine levels. An ultrasound scan of his abdomen affirmed the presence of normal adrenal glands. With intravenously administered hydrocortisone and orally administered levothyroxine replacement, he showed marked clinical improvement that supported the diagnosis of hypopituitarism. CONCLUSION: Hyponatremia in the elderly is not an uncommon presentation. However, etiological diagnosis is a challenging task as there are multiple overlapping differential diagnoses.
13 schema:genre research_article
14 schema:inLanguage en
15 schema:isAccessibleForFree true
16 schema:isPartOf N503799969503429cb2c51b82d9985fe4
17 Nd08c49c38aa546a9bafecfa51213f32f
18 sg:journal.1038062
19 schema:name Pituitary macroadenoma presenting as severe hyponatremia: a case report
20 schema:pagination 40
21 schema:productId N05086f926bc64fe28bbcc208a3a87da3
22 N35baab962edd492fa6650b283c4c5afe
23 N93cfcea7622f496ca81a0ed0734d21e5
24 Naf2fd1e9667748cab15b4f3f70992192
25 Nf0d2876a6b9a46b895b480119f3c2750
26 schema:sameAs https://app.dimensions.ai/details/publication/pub.1112315672
27 https://doi.org/10.1186/s13256-019-2000-4
28 schema:sdDatePublished 2019-04-11T10:59
29 schema:sdLicense https://scigraph.springernature.com/explorer/license/
30 schema:sdPublisher Nd27d4480c01a426d83bed73fadab389d
31 schema:url https://link.springer.com/10.1186%2Fs13256-019-2000-4
32 sgo:license sg:explorer/license/
33 sgo:sdDataset articles
34 rdf:type schema:ScholarlyArticle
35 N05086f926bc64fe28bbcc208a3a87da3 schema:name doi
36 schema:value 10.1186/s13256-019-2000-4
37 rdf:type schema:PropertyValue
38 N077f555715ef4057870bec2e94721a08 schema:affiliation https://www.grid.ac/institutes/grid.416931.8
39 schema:familyName Medagedara
40 schema:givenName Chathuranga
41 rdf:type schema:Person
42 N35baab962edd492fa6650b283c4c5afe schema:name pubmed_id
43 schema:value 30795800
44 rdf:type schema:PropertyValue
45 N503799969503429cb2c51b82d9985fe4 schema:volumeNumber 13
46 rdf:type schema:PublicationVolume
47 N699d2924fc124c6e96390b166f426c72 schema:affiliation https://www.grid.ac/institutes/grid.416931.8
48 schema:familyName Bopeththa
49 schema:givenName Bopeththe Vidanelage Kameera Madhusanka
50 rdf:type schema:Person
51 N82607068048249d991515b430f23bbde rdf:first N077f555715ef4057870bec2e94721a08
52 rdf:rest rdf:nil
53 N93cfcea7622f496ca81a0ed0734d21e5 schema:name dimensions_id
54 schema:value pub.1112315672
55 rdf:type schema:PropertyValue
56 Na4b63fc22db4415b8d105689937b727c rdf:first Ne5ef6524da9748589e8f60623fce270f
57 rdf:rest N82607068048249d991515b430f23bbde
58 Naf2fd1e9667748cab15b4f3f70992192 schema:name nlm_unique_id
59 schema:value 101293382
60 rdf:type schema:PropertyValue
61 Nd08c49c38aa546a9bafecfa51213f32f schema:issueNumber 1
62 rdf:type schema:PublicationIssue
63 Nd27d4480c01a426d83bed73fadab389d schema:name Springer Nature - SN SciGraph project
64 rdf:type schema:Organization
65 Ne5ef6524da9748589e8f60623fce270f schema:affiliation https://www.grid.ac/institutes/grid.416931.8
66 schema:familyName Niyaz
67 schema:givenName S. M. M.
68 rdf:type schema:Person
69 Nf0d2876a6b9a46b895b480119f3c2750 schema:name readcube_id
70 schema:value 7c7355dcf03d51c745a24be127010bb0f68ce1b9deb29243cb67f09f28993c75
71 rdf:type schema:PropertyValue
72 Nfceb0d234b594264bbabff76b9476196 rdf:first N699d2924fc124c6e96390b166f426c72
73 rdf:rest Na4b63fc22db4415b8d105689937b727c
74 anzsrc-for:11 schema:inDefinedTermSet anzsrc-for:
75 schema:name Medical and Health Sciences
76 rdf:type schema:DefinedTerm
77 anzsrc-for:1103 schema:inDefinedTermSet anzsrc-for:
78 schema:name Clinical Sciences
79 rdf:type schema:DefinedTerm
80 sg:journal.1038062 schema:issn 1752-1947
81 schema:name Journal of Medical Case Reports
82 rdf:type schema:Periodical
83 sg:pub.10.1007/s40618-016-0487-8 schema:sameAs https://app.dimensions.ai/details/publication/pub.1023171086
84 https://doi.org/10.1007/s40618-016-0487-8
85 rdf:type schema:CreativeWork
86 https://app.dimensions.ai/details/publication/pub.1079063792 schema:CreativeWork
87 https://doi.org/10.1016/j.arr.2012.04.006 schema:sameAs https://app.dimensions.ai/details/publication/pub.1029642928
88 rdf:type schema:CreativeWork
89 https://doi.org/10.1016/j.jecr.2017.05.001 schema:sameAs https://app.dimensions.ai/details/publication/pub.1085612903
90 rdf:type schema:CreativeWork
91 https://doi.org/10.2215/cjn.04431007 schema:sameAs https://app.dimensions.ai/details/publication/pub.1035081257
92 rdf:type schema:CreativeWork
93 https://doi.org/10.3121/cmr.2007.762 schema:sameAs https://app.dimensions.ai/details/publication/pub.1036571817
94 rdf:type schema:CreativeWork
95 https://www.grid.ac/institutes/grid.416931.8 schema:alternateName Teaching Hospital Kandy
96 schema:name Department of Surgery, Teaching Hospital, Kandy, Sri Lanka
97 Emergency Medicine, Teaching Hospital, kandy, 70500, Kandy, Sri Lanka
98 rdf:type schema:Organization
 




Preview window. Press ESC to close (or click here)


...