• Yudai Hinata, Nobumasa Ohara, Takeshi Komatsu, Yuki Sakurai, Yuichiro Yoneoka, Yasuhiro Seki, Katsuhiko Akiyama, and Hirohito Sone.
• Department of Endocrinology and Metabolism, Uonuma Kikan Hospital, Japan.
• Intern. Med. 2022 Jan 15; 61 (2): 197-203.

AbstractA 49-year-old man developed severe hyponatremia associated with transient headache and was diagnosed with syndrome of inappropriate antidiuretic hormone secretion (SIADH). Fluid restriction and sodium supplementation corrected the hyponatremia. However, several days later, the patient exhibited hypernatremia with thirst and polyuria. A detailed examination indicated central diabetes insipidus (CDI) with an intrasellar cystic lesion indicative of Rathke's cleft cyst (RCC). A case of RCC exhibiting headache, hyponatremia, and subsequent hypernatremia has been reported. Our case shows that CDI may appear after SIADH in patients with RCC, especially in those with serum sodium levels that unexpectedly increase rapidly beyond the reference range.

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