Severe Hyponatremia Caused by Hypothalamic Adrenal Insufficiency.

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  • SHIBATA Takahisa
    The Second Department of Internal Medicine, Chiba University School of Medicine
  • OEDA Toru
    The Second Department of Internal Medicine, Chiba University School of Medicine
  • SAITO Yasushi
    The Second Department of Internal Medicine, Chiba University School of Medicine

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A 60-year-old woman was admitted with severe hyponatremia. Basal values of adrenocorticotropic hormone (ACTH), thyroid hormone and cortisol were normal on admission. Impairment of water diuresis was observed by water loading test. Initially, we diagnosed her condition as the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). By provocation test, we finally confirmed that the hyponatremia was caused by hypothalamic adrenal insufficiency. The basal values of ACTH and cortisol might not be sufficient to exclude the possibility of adrenal insufficiency. Therefore, it is necessary to evaluate adrenal function by provocation test or to re-evaluate it after recovery from hyponatremia.<br>(Internal Medicine 38: 426-432, 1999)

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  • Internal Medicine

    Internal Medicine 38 (5), 426-432, 1999

    一般社団法人 日本内科学会

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