ArticleJCEM case reports2026
Tirzepatide-associated hyponatremia in a patient with known arginine vasopressin deficiency.
Article in JCEM case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
This report describes a 53-year-old female individual with known arginine vasopressin deficiency (AVP-D) due to a recurrent Rathke cleft cyst (RCC), with asymptomatic severe hyponatremia (sodium 121 mEq/L [SI: 121 mmol/L]; reference range 135-145 mEq/L [SI: 135-145 mmol/L]) in the setting of several months of tirzepatide use for weight loss. On review of the literature this is the third case of severe hyponatremia (sodium ≤125 mEq/L [SI: ≤125 mmol/L]) reported with the use of tirzepatide and first case in someone with AVP-D. Although hyponatremia associated with tirzepatide is rare, it poses a significant risk for individuals with AVP-D, who are already predisposed to hyponatremia. Clinicians should remain vigilant regarding this potential complication, provide education on desmopressin escape strategies, and carefully consider reductions in desmopressin dosing when co-administering with tirzepatide.
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