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Macroprolactinoma-Induced Syndrome of Inappropriate Antidiuresis and Its Reversal with Dopamine Agonist Therapy.
- Source :
-
Laboratory medicine [Lab Med] 2022 Sep 01; Vol. 53 (5), pp. 537-539. - Publication Year :
- 2022
-
Abstract
- Hyponatremia is an uncommon manifestation of pituitary adenomas. Herein, I report a case of syndrome of inappropriate antidiuresis (SIAD) caused by a macroprolactinoma that rapidly resolved with dopamine agonist therapy. A 29-year-old White woman presented with euvolemic, hypotonic hyponatremia, normal thyroid and glucocorticoid axes, and inappropriately concentrated urine. She was found to have a 1.2-cm sellar mass. Investigation of additional pituitary axes revealed an elevated prolactin level of 193.7 ng/mL. The SIAD experienced by the patient corrected rapidly with initiation of cabergoline. The patient could not tolerate dopamine agonist therapy, and after 1 year, she underwent transsphenoidal resection of the mass after the prolactin began to increase. Pathological examination confirmed the diagnosis of macroprolactinoma. There was no recurrence of the tumor, and the patient continued to have normonatremia and normoprolactinemia 7 years after her operation. To my knowledge, this is the first report in the literature of pathology-confirmed macroprolactinoma marked by SIAD that showed rapid normalization of water metabolism with dopamine agonist therapy.<br /> (© The Author(s) 2022. Published by Oxford University Press on behalf of American Society for Clinical Pathology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
- Subjects :
- Adult
Dopamine Agonists therapeutic use
Female
Humans
Prolactin
Hyponatremia diagnosis
Hyponatremia drug therapy
Hyponatremia etiology
Pituitary Neoplasms complications
Pituitary Neoplasms diagnosis
Pituitary Neoplasms drug therapy
Prolactinoma complications
Prolactinoma diagnosis
Prolactinoma drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1943-7730
- Volume :
- 53
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Laboratory medicine
- Publication Type :
- Academic Journal
- Accession number :
- 35552737
- Full Text :
- https://doi.org/10.1093/labmed/lmac025