Diabetes Insipidus pada Pasien Pascaoperasi Tumor Hipofisis
Abstract
Pembedahan pada tumor hipofisis dapat menyebabkan penurunan fungsi hipofisis, salah satunya adalah defisiensi antidiuretic hormone (ADH) yang dapat menyebabkan diabetes insipidus. Laporan kasus: Pasien perempuan 48 tahun, dengan diagnosis tumor sella-suprasella disertai visual loss, hipotiroid, hipoprolaktin, dan hipokortisol. Operasi berjalan 4 jam dengan tatalaksana general anestesi teknik proteksi otak. Pasca operasi pasien mengalami diabetes insipidus dengan klinis poliuriaa sampai lebih dari 6000 cc perhari. Dilakukan perawatan intensif dengan pemantauan ketat di Intensive Care Unit (ICU). Penggantian cairan dan pemberian desmopressin acetate kombinasi dengan vasopressin dilakukan sebagai terapi. Setelah perawatan 12 hari terjadi perbaikan klinis dan laboratoris. Tatalaksana dan monitoring yang tepat akan kejadian diabetes insipidus yang dapat mencegah terjadinya perburukan kondisi pada pasien.
Diabetes Insipidus in Patient with Postoperative Pituitary Tumor
Abstract
Surgery on a pituitary tumor can cause a decrease in pituitary function,: like deficiency antidiuretic hormone which cause diabetes insipidus. Case report: A 48-year-old female patient, with a diagnosis of sella-suprasella tumor accompanied by visual loss, hypothyroidism, hypoprolactin, and hypocortisol. The operation lasted 4 hours under general anesthesia with brain protection techniques. Postoperatively the patient had diabetes insipidus with clinical poliuriaa up to more than 6000 cc per day. Intensive care is carried out with close monitoring in the Intensive Care Unit. Fluid replacement and administration of desmopressin acetate in combination with vasopressin is performed as therapy. After 12 days of treatment, there was clinical and laboratory improvement. Appropriate management and monitoring of the incidence of diabetes insipidus can prevent the worsening of the patient's condition.
Keywords
Full Text:
PDFReferences
Molitch, M. Diagnosis and Treatment of pituitary adenomas a review. JAMA. 2017; 31(5):516-524. Doi: https://doi.org/10.1001/jama.2016.19699.
Banskota S, Adamson DC. Pituitary adenomas: From diagnosis to therapeutics. Biomedicines 2021;9(5):494. Doi: https://doi.org/10.3390/biomedicines9050494
Christ-Crain M, Bichet DG, Fenske WK, Goldman MB, Rittig S, et al. Diabetes Insipidus. Nat Rev Primers. 2019;5(1):54. Doi: https://doi.org/10.1038/s41572-019-0103-2
Gardner DG, Shoback D. Greenspan's Basic & Clinical Endocrinology. 10th Ed. McGraw. 2017.
Badmaeva IN, Astafieva LI, Kalinin PL, Kadashev BA, Kutin MA. Central diabetes insipidus after resection of sellar-suprasellar tumors: prevalence and predictors of manifestation. Zh Vopr Neirokhir Im NN Burdenko. 2021;85(6):111-18. Doi: 10.17116/neiro202185051111
Mutter CM, Smith T, Menze O, Zakharia M, Nguyen H. Diabetes Insipidus: Pathogenesis, diagnosis, and clinical management. Cureus. 2021;13(2):e13523. doi: https://doi.org/10.7759/cureus.13523.
Hui C, Khan M, Khan Suheb MZ, Radbel JM. Diabetes insipidus. [Updated 2023 Jan 2]. StatPearls [Internet]. Tersedia dari: https://www.ncbi.nlm.nih.gov/books/NBK470458
Laksono, BH, Oetoro BJ, Rahardjo S, Saleh SC. Gangguan natrium pada pasien bedah saraf. J. neuroanestesi Indones. 2014;3(1):48–57. DOI: https://doi.org/10.24244/jni.vol3i1.132
Fithrah B, Rasman M, Saleh S. Pengelolaan central diabetes insipidus pasca cedera kepala. J. neuroanestesi Indones. 2019; 8 (2):99–104. Doi: https://doi.org/10.24244/jni.v8i2.219
Kim RJ, Malattia C, Allen M, Moshang Jr T, Maghnie M. Vasopressin and desmopressin in central diabetes insipidus: Adverse effects and clinical considerations. Pediatr Endocrinol Rev. 2044; (2Suppl), 1: 115–126.
Garrahy A, Moran C, Thompson CJ. Diagnosis and management of central diabetes insipidus in adults. Clin Endocrinol. 2019;90(1):23–30.Doi:https://doi.org/10.1111/cen.13866
DOI: https://doi.org/10.24244/jni.v12i3.553
Refbacks
- There are currently no refbacks.
JNI is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License