18 December 2020
: Case report 
Masked Diabetes Insipidus Hidden by Severe Hyponatremia: A Case of Pituitary Metastasis of Lung Adenocarcinoma
Unusual clinical course, Challenging differential diagnosis, Unusual or unexpected effect of treatment, Diagnostic / therapeutic accidents, Adverse events of drug therapy, Educational Purpose (only if useful for a systematic review or synthesis)
Miki Watanabe1ABCDEF, Junichi Yasuda1CDEF, Kenji Ashida1ABCDEF*, Yuko Matsuo1CDE, Ayako Nagayama1CDE, Yuka Goto1CDE, Shimpei Iwata1CDE, Masayuki Watanabe2CDE, Jun Sasaki2BCDE, Tomoaki Hoshino2CDE, Masatoshi Nomura3ACDEFDOI: 10.12659/AJCR.928113
Am J Case Rep 2020; 21:e928113
Figure 3. Clinical course of the present case. Administration of oral and intravenous sodium chloride transiently increased the serum sodium concentration at first admission; however, fatigue and anorexia persisted. Hydrocortisone administration followed by levothyroxine replacement increased the sodium concentration up to 151 mmol/L. Desmopressin administration was required to attenuate the hypernatremia caused by the masked diabetes insipidus. Open circles with solid line represent serum sodium concentration, and closed circles with broken line represent urine specific gravity.