SIADH and partial hypopituitarism in a patient with intravascular large B-cell lymphoma: a rare cause of a common presentation

Hyponatraemia is a very common electrolyte abnormality with varied presenting features depending on the underlying cause. The authors report the case of a 75-year-old, previously fit, gentleman who presented with weight loss, lethargy and blackouts. He required four admissions to the hospital over a...

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Bibliographic Details
Published in:BMJ case reports 2013-01, Vol.2013, p.bcr2012007147
Main Authors: Akhtar, Simeen, Cheesman, Edmund, Jude, Edward B
Format: Article
Language:English
Subjects:
Aged
Biopsy
Bone marrow
Embolisms
Endocrinology
Fatal Outcome
Growth hormones
Humans
Hyponatremia - etiology
Hypopituitarism - etiology
Inappropriate ADH Syndrome - etiology
Lymphoma
Lymphoma, Large B-Cell, Diffuse - complications
Lymphoma, Large B-Cell, Diffuse - diagnosis
Lymphoma, Large B-Cell, Diffuse - pathology
Male
Mortality
Patients
Pituitary gland
Sodium
Testosterone
Thyroid gland
United Kingdom
Unusual Association of Diseases/Symptoms
Urine
Vascular Neoplasms - complications
Vascular Neoplasms - diagnosis
Vascular Neoplasms - pathology
White
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Summary:Hyponatraemia is a very common electrolyte abnormality with varied presenting features depending on the underlying cause. The authors report the case of a 75-year-old, previously fit, gentleman who presented with weight loss, lethargy and blackouts. He required four admissions to the hospital over an 8-month period. Investigations revealed persistent hyponatraemia consistent with a diagnosis of syndrome of inappropriate antidiuretic hormone secretion, macrocytic anaemia and partial hypopituitarism. Unfortunately, all other investigations that were performed failed to identify the underlying cause and a diagnosis of intravascular large B-cell lymphoma was only confirmed following postmortem studies. The authors recommend that endocrinologists should be involved at the outset in the management of patients with persistent hyponatraemia and that intravascular large B-cell lymphoma should be considered in the differential diagnosis of hyponatraemia.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2012-007147