Hyponatremia associated with Chronic Pituitary Apoplexy Masquerading as SIADH

Authors

  • Md Imran Ahmed Specialist, Critical Care Medicine, Unico Hospitals, Dhaka
  • Umme Kulsum Chy Consultant, Critical Care Medicine, Unico Hospitals, Dhaka
  • Farah Yeasmin Specialist, Critical Care Medicine, Unico Hospitals, Dhaka
  • Mohammad Omar Faruq Senior Consultant, Critical Care Medicine, Unico Hospitals, Dhaka
  • Ishtiaq Ahmad Consultant, Clinical & interventional Neurology, Unico Hospitals, Dhaka

DOI:

https://doi.org/10.3329/bccj.v14i1.88319

Keywords:

Adrenal insufficiency, Hyponatremia, Pituitary apoplexy, SIADH

Abstract

Pituitary apoplexy, while classically acute, can present insidiously as chronic apoplexy, posing significant diagnostic challenges. We report a 60-year-old male with multiple comorbidities who presented with progressive weakness and neck pain following a gastrointestinal illness. He was found to have severe symptomatic hyponatremia (Na+ 115 mmol/L) with a biochemical profile suggestive of the Syndrome of Inappropriate Anti-Diuretic Hormone (SIADH). Brain MRI demonstrated sellar–suprasellar pituitary mass with heterogeneous signal intensity and hemorrhagic components, showing peripheral rim enhancement on gadolinium-enhanced. Further evaluation revealed a profoundly low serum cortisol (< 1.8 μg/dL) and low prolactin. This case underscores that a patient with adrenal insufficiency secondary to chronic pituitary apoplexy may present as hyponatremia with SIADH-like features.

Bangladesh Crit Care J March 2026; 14 (1): 52-54

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Published

2026-04-08

How to Cite

Ahmed, M. I., Chy, U. K., Yeasmin, F., Faruq, M. O., & Ahmad, I. (2026). Hyponatremia associated with Chronic Pituitary Apoplexy Masquerading as SIADH. Bangladesh Critical Care Journal, 14(1), 52–54. https://doi.org/10.3329/bccj.v14i1.88319

Issue

Vol. 14 No. 1 (2026)

Section

Case Reports

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