OBJECTIVE: To investigate the etiology, clinical characteristics and treatment of pituitary adenoma with hyponatremia as the first symptom.
METHODS: To retrospectively analyze the clinical data of 28 patients with pituitary adenoma admitted to neurosurgery with hyponatremia as the first symptom, and to explore their etiology, clinical characteristics and treatment methods.
RESULTS: There were 27 cases of pituitary non-functional adenoma and 1 case of prolactin adenoma in this group. There were 23 cases of pituitary macroadenoma and 5 cases of giant adenoma. There were 22 cases of total resection of tumor through the pterygoid sinus approach and 2 cases of major resection; 4 cases were treated conservatively. There were 13 cases of preoperative combined adrenal hypofunction, 8 cases of hypothyroidism, 5 cases of both adrenal and thyroid hypofunction, and 2 cases of hyponatremia due to SIADH. The hyponatremia was corrected by hormone supplementation and water restriction during the perioperative period and postoperatively.
Conclusion: Patients with pituitary adenoma starting with hyponatremia are mostly pituitary non-functional macroadenoma and mostly elderly patients. Pituitary adenoma resection is the treatment of choice for this disease, and hyponatremia and anterior pituitary hypofunction should be corrected during the perioperative period, and close follow-up should be performed after surgery.