{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T09:48:07Z","timestamp":1776851287967,"version":"3.51.2"},"reference-count":12,"publisher":"The Endocrine Society","issue":"5","license":[{"start":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T00:00:00Z","timestamp":1776816000000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,21]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>A previously healthy 24-year-old man presented with subacute worsening headache. Initial evaluation revealed euvolemic hypotonic hyponatremia and central hypothyroidism. Brain magnetic resonance imaging (MRI) demonstrated a sellar lesion concerning for a Rathke cleft cyst vs hemorrhagic macroadenoma. His hyponatremia was initially attributed to syndrome of inappropriate antidiuretic hormone and treated with fluid restriction and hypertonic saline. However, his hyponatremia and neurologic symptoms worsened. Given the patient's headache and sellar pathology, pituitary apoplexy was considered. A pituitary panel was obtained and empiric hormone replacement therapy initiated with IV hydrocortisone (100\u2005mg every 6\u2005hours) and levothyroxine (100\u2005mcg daily). His symptoms and laboratory abnormalities improved to near-complete resolution within 72\u2005hours. Pituitary testing confirmed panhypopituitarism. The patient was discharged on levothyroxine and a hydrocortisone taper. A follow-up pituitary MRI demonstrated interval reduction in lesion size. At 6-month follow-up, recovery of the pituitary axes was observed except for residual GH deficiency. Pituitary apoplexy is a medical emergency requiring prompt recognition and initiation of hormone replacement therapy. Secondary adrenal failure may cause hyponatremia that is refractory to standard therapy, thus mandating its consideration in this setting.<\/jats:p>","DOI":"10.1210\/jcemcr\/luag052","type":"journal-article","created":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T12:54:24Z","timestamp":1771505664000},"source":"Crossref","is-referenced-by-count":0,"title":["Pituitary apoplexy presenting as refractory hyponatremia"],"prefix":"10.1210","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8787-279X","authenticated-orcid":false,"given":"Samira","family":"Chandra","sequence":"first","affiliation":[{"name":"Department of Medicine, Baptist Health - UAMS Internal Medicine Residency Program , North Little Rock, AR 72117 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6481-9771","authenticated-orcid":false,"given":"Thomas","family":"Banh","sequence":"additional","affiliation":[{"name":"Department of Medicine, Baptist Health - UAMS Internal Medicine Residency Program , North Little Rock, AR 72117 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Soumya","family":"Thumma","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Baptist Health - UAMS Internal Medicine Residency Program , North Little Rock, AR 72117 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shrikant","family":"Tamhane","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Baptist Health - UAMS Internal Medicine Residency Program , North Little Rock, AR 72117 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis Augusto","family":"Juncos","sequence":"additional","affiliation":[{"name":"FME Global Medical Office, Medical Affairs, Fresenius Medical Care , Waltham, MA 02451 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a case report","volume":"47","author":"Iwai","year":"2000","journal-title":"Endocr J"},{"issue":"7","key":"2026042204493901300_luag052-B7","doi-asserted-by":"crossref","first-page":"e14295","DOI":"10.1097\/MD.0000000000014295","article-title":"Be aware of the effects of glucocorticoids on SIADH: a case report","volume":"98","author":"Li","year":"2019","journal-title":"Medicine (Baltimore)"},{"issue":"1","key":"2026042204493901300_luag052-B8","doi-asserted-by":"crossref","first-page":"R15","DOI":"10.1530\/EJE-16-0493","article-title":"MANAGEMENT OF ENDOCRINE DISEASE: hypothyroidism-associated hyponatremia: mechanisms, implications and treatment","volume":"176","author":"Liamis","year":"2017","journal-title":"Eur J Endocrinol"},{"issue":"5S22","key":"2026042204493901300_luag052-B9","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1002\/j.2040-4603.1999.tb01498.x","article-title":"Antidiuretic hormone: synthesis and 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