Is Tolvaptan in the Treatment of SIADH Following Pituitary Surgery a Right Choice?

Abstract

Background: Fluid and electrolyte disturbances, especially hyponatremia are common complications after pituitary surgeries. Syndrome of inappropriate antidiuretic hormone secretion SIADH is the leading cause of hyponatremia in hospitals. Fluid restriction is the first step in treatment of SIADH. In rare cases vasopressin receptor inhibitors might be useful for medical treatment. Case Presentation: In this paper, we present a case of SIADH after a pituitary surgery with an unpredictable effect of tolvaptan. Conclusion: Tolvaptan is the most preferred agent for the treatment of SIADH nowadays. However tolvaptan might cause unpredictable situations in the course of treatment that clinicians must be very careful and in close follow up the patient.