Hypernatremia-Induced Rhabdomyolysis in a Patient with Meningioma Involving the Pituitary Gland / 대한내과학회지

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.