Hyponatremia with Loss of High Signal Intensity in the Posterior Pituitary Lobe on T1-weighted Magnetic Resonance Imaging

Masayuki Kitagawa; Yoshihiro Yamanaka; Toru Adachi; Junitsu Ito; Kazutoshi Fukase; Ikuro Ohta; Tadashi Katagiri

doi:10.2169/internalmedicine.8616-16

CASE REPORTS

Hyponatremia with Loss of High Signal Intensity in the Posterior Pituitary Lobe on T1-weighted Magnetic Resonance Imaging

Masayuki Kitagawa, Yoshihiro Yamanaka, Toru Adachi, Junitsu Ito, Kazutoshi Fukase, Ikuro Ohta, Tadashi Katagiri

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Keywords: hyponatremia, lack of high signal intensity in the posterior pituitary lobe, depletion of the posterior pituitary

JOURNAL OPEN ACCESS

2017 Volume 56 Issue 23 Pages 3205-3209

DOI https://doi.org/10.2169/internalmedicine.8616-16

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Abstract

Herein, we report on an 82-year-old woman who presented with anorexia. The patient had hyponatremia with preserved urinary osmotic pressure. T1-weighted magnetic resonance imaging (MRI) showed a lack of high signal intensity (SI) in the posterior pituitary lobe. Based on the patient's high levels of N-terminal prohormone of brain natriuretic peptide (NT-proBNP), heart failure was suspected. The heart failure may have caused arginine vasopressin (AVP) secretion. The depletion of AVP secretory granules may therefore cause the posterior pituitary gland to disappear on T1-weighted MRI.

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