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Case Report
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Korean J Med. 2015;88(3):324-329. Published online March 1, 2015.
DOI: https://doi.org/10.3904/kjm.2015.88.3.324
- 뇌하수체 침범 뇌수막종 환자에서 고나트륨혈증에 의한 횡문근 융해증
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이혜원1, 윤종민1, 허주연1, 김지은1, 김영주2, 서경진3, 김영옥1
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1가톨릭대학교 의과대학 내과학교실
2가톨릭대학교 의과대학 영상의학교실
3가톨릭대학교 의과대학 병리학교실
- Hypernatremia-Induced Rhabdomyolysis in a Patient with Meningioma Involving the Pituitary Gland
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Hye Won Lee1, Jong Min Yun1, Joo Yeun Hu1, Ji Eun Kim1, Young Joo Kim2, Kyung Jin Seo3, Young Ok Kim1
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1Departments of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
2Departments of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Korea
3Departments of Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Corresponding author: Young Ok Kim ,Tel: +82-31-820-3347, Fax: +82-31-847-2719, Email: cmckyo@catholic.ac.kr
- Received: April 21, 2014; Revised: May 22, 2014 Accepted: June 27, 2014.
- 횡문근 융해증의 원인에 고나트륨혈증이 속해 있지만 보고된 증례는 드물다. 본 저자들은 뇌하수체를 침범하는 거대 뇌수막종 환자에서 중추성 요붕증으로 인한 것으로 추정되는 고나트륨혈증에 의해 횡문근 융해증이 발생한 환자를 경험했다. 데스모프레신 투여 후에 고나트륨혈증 및 횡문근 융해증이 함께 호전되는 임상경과를 보인 증례를 경험했기에 문헌고찰과 함께 보고하는 바이다.
߽ɾ :횡문근 융해증; 고나트륨혈증; 중추성 요붕증; 뇌하수체
- Abstract
- Hypernatremia is a rare cause of rhabdomyolysis. Here, we report a case of hypernatremia-induced rhabdomyolysis in a patient with meningioma involving the pituitary gland. A 61-year-old male was admitted for decreased mentality and poor oral intake. He had undergone an operation for meningioma 10 years prior. At admission, he appeared lethargic and severely dehydrated with an initial sodium level of 178 mEq/L. Hypernatremia remained persistent despite massive hydration and the serum creatine phosphokinase level was 18,047 U/L after 3 days. Bone scintigraphy also showed findings consistent with rhabdomyolysis. Brain magnetic resonance imaging revealed extensive masses involving the pituitary gland and an intranasal biopsy confirmed meningioma. Polyuria, and low anti-diuretic hormone levels supported the diagnosis of central diabetes insipidus-induced hypernatremia. Desmopressin was administered intranasally and the patient’s serum sodium and muscle enzyme levels were normalized.
Keywords :Rhabdomyolysis, Hypernatremia, Diabetes insipidus, Pituitary gland
