{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T05:56:29Z","timestamp":1770962189241,"version":"3.50.1"},"reference-count":11,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,6,12]]},"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:p>A 57-year-old woman presented with severe lethargy, dizziness and nausea 1 week after transsphenoidal resection of a growth hormone secreting pituitary adenoma. She was found to have severe hyponatremia of 115 mmol\/L. Importantly, she was neurologically intact and clinically euvolaemic. Her fluid intake was restricted and her sodium levels increased to 131 mmol\/L over 4 days. She made a full recovery.<\/jats:p>\n               <jats:p>She was diagnosed with isolated second-phase diabetes insipidus, a state of symptomatic hypoosmolar hyponatremia that usually occurs 7\u201310 days after transsphenoidal surgery. The sodium levels improve with fluid restriction.<\/jats:p>","DOI":"10.1136\/bcr-2020-235499","type":"journal-article","created":{"date-parts":[[2020,6,30]],"date-time":"2020-06-30T15:49:58Z","timestamp":1593532198000},"page":"e235499","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Isolated second-phase diabetes insipidus post-transsphenoidal surgery"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8676-4233","authenticated-orcid":false,"given":"Annalisa","family":"Montebello","sequence":"first","affiliation":[{"name":"Department of Diabetes and Endocrinology, Mater Dei Hospital, Msida, Malta"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Darryl","family":"Portelli","sequence":"additional","affiliation":[{"name":"Department of General Internal Medicine, Mater Dei Hospital, Msida, Malta"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Gruppetta","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology, Mater Dei Hospital, Msida, Malta"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,6,30]]},"reference":[{"key":"2025082712160695000_13.6.e235499.1","doi-asserted-by":"publisher","DOI":"10.1530\/EC-16-0058"},{"key":"2025082712160695000_13.6.e235499.2","doi-asserted-by":"crossref","first-page":"e15","DOI":"10.1016\/j.endonu.2014.01.005","article-title":"Clinical guidelines for management of diabetes insipidus and syndrome of inappropriate antidiuretic hormone secretion after pituitary surgery","volume":"61","author":"Lamas","year":"2014","journal-title":"Endocrinol Nutr"},{"key":"2025082712160695000_13.6.e235499.3","doi-asserted-by":"publisher","DOI":"10.14740\/jocmr2041w"},{"key":"2025082712160695000_13.6.e235499.4","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1159\/000370065","article-title":"Management of electrolyte and fluid disorders after brain surgery for pituitary\/suprasellar tumours","volume":"83","author":"Edate","year":"2015","journal-title":"Horm Res Paediatr"},{"key":"2025082712160695000_13.6.e235499.5","doi-asserted-by":"publisher","DOI":"10.1093\/bjaceaccp\/mkh040"},{"key":"2025082712160695000_13.6.e235499.6","doi-asserted-by":"crossref","first-page":"66","DOI":"10.3171\/jns.2007.106.1.66","article-title":"Recognition and management of delayed hyponatremia following transsphenoidal pituitary surgery","volume":"106","author":"Zada","year":"2007","journal-title":"J Neurosurg"},{"key":"2025082712160695000_13.6.e235499.7","doi-asserted-by":"publisher","DOI":"10.3171\/2008.9.JNS08191"},{"key":"2025082712160695000_13.6.e235499.8","doi-asserted-by":"publisher","DOI":"10.1210\/jc.79.5.1395"},{"key":"2025082712160695000_13.6.e235499.9","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1227\/00006123-199510000-00007","article-title":"Delayed onset of hyponatremia after transsphenoidal surgery for pituitary adenomas","volume":"37","author":"Taylor","year":"1995","journal-title":"Neurosurgery"},{"key":"2025082712160695000_13.6.e235499.10","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2265.1999.00666.x"},{"key":"2025082712160695000_13.6.e235499.11","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1995.83.2.0363"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-235499","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T19:16:12Z","timestamp":1756322172000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-235499"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6]]},"references-count":11,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2020,6,30]]},"published-print":{"date-parts":[[2020,6]]}},"alternative-id":["10.1136\/bcr-2020-235499"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-235499","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,6]]}}}