Reset osmostat syndrome — when hyponatremia become «a normal»: diagnostics, case report

• DOI: 10.14341/probl13235
• Publication Date: 2023-11-14T09:56:36Z
• Authors: L. I. Astafyeva; I. N. Badmaeva; I. S. Klochkova; Yu. G. Sidneva; O. I. Sharipov; O. A. Gadjieva; B. A. Bashiryan; P. L. Kalinin; A. Yu. Lubnin; A. N. Konovalov
• Keywords: Hypernatremia; Urine sodium; Urine osmolality; Plasma osmolality

Reset osmostat syndrome (ROS) is characterized by a change of normal plasma osmolality threshold (decrease or increase), which leads to chronic dysnatremia (hypo- hypernatremia). We have described clinical case ROS and hyponatremia in patient with chordoid glioma the III ventricle. It known that had previously been diagnosed (131–134 mmol/l). She has not hypothyroidism hypocorticism. There filtration function kidneys was (CKD-EPI 91.7 ml/mi/1,73m 2 ). Urine sodium level were studied exclude concentration kidney disorder. During first three days after removal tumor third ventricle (chordoid glioma, WHO Grade II), decreased 119 mmol/l. Repeated infusions 200–300 ml hypertonic 3% chloride solution, gluco- mineralocorticoid therapy ineffective, increasing levels 2–3 mmol/l return initial during 6–8 hours. Hypopituitary disorders did develop surgery. With further observation, remained within 126–129 for 6 months The water load test make classic inappropriate secretion antidiuretic hormone, confirmed diagnosis RSO. Because absence symptoms associated hyponatremia, no medical correction required, recommended follow-up.