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Hypodipsic hypernatremia leading to reversible renal failure following surgery for craniopharyngioma

Authors
 Ah Reum Kwon  ;  Jung-Min Ann  ;  Jae Il Shin  ;  Hyun Wook Chae  ;  Ho-Seong Kim 
Citation
 JOURNAL OF PEDIATRIC ENDOCRINOLOGY & METABOLISM, Vol.25(9-10) : 1027-1030, 2012 
Journal Title
 JOURNAL OF PEDIATRIC ENDOCRINOLOGY & METABOLISM 
ISSN
 0334-018X 
Issue Date
2012
MeSH
Acute Kidney Injury/etiology* ; Adolescent ; Craniopharyngioma/complications ; Craniopharyngioma/surgery* ; Humans ; Hypernatremia/complications* ; Male ; Pituitary Neoplasms/complications ; Pituitary Neoplasms/surgery* ; Thirst/physiology*
Keywords
craniopharyngioma ; hypernatremia ; hypodipsia ; renal failure
Abstract
Thirst is stimulated by increases in effective plasma osmolality that are detected by cerebral osmoreceptors located in the vascular organ of the lamina terminalis. However, surgical destruction or organic lesions of the lamina terminalis decrease the sensation of thirst in response to increased plasma osmolality. A 17-year-old boy who was diagnosed with craniopharyngioma at the age of 10 years and underwent tumor resection and gamma knife surgery was admitted for non-symptomatic severe hypernatremia. Although the sodium level was 173 mmol/L and serum osmolality was also high (371 mOsm/kg), the patient did not report increased thirst. Laboratory analysis revealed hypertonic dehydration and acute non-oliguric renal failure due to dehydration. Treatment was based on correction of hypernatremia with hydration and education about regular, periodic water ingestion. The patient's hypernatremia and acute non-oliguric renal failure resolved with controlled daily fluid intake. To our knowledge, this is the first report of decreased thirst sensation secondary to craniopharyngioma and tumor resection leading to severe hypernatremia and non-oliguric renal failure in an adolescent.
Full Text
http://www.degruyter.com/doi/10.1515/jpem-2012-0176
DOI
23426838
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
Yonsei Authors
Kwon, Ah Reum(권아름) ORCID logo https://orcid.org/0000-0002-9692-2135
Kim, Ho Seong(김호성) ORCID logo https://orcid.org/0000-0003-1135-099X
Shin, Jae Il(신재일) ORCID logo https://orcid.org/0000-0003-2326-1820
Chae, Hyun Wook(채현욱) ORCID logo https://orcid.org/0000-0001-5016-8539
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/91033
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