Severe hyponatremia due to hypopituitarism with adrenal insufficiency: A case report

2007 ◽  
Vol 30 (8) ◽  
pp. 684-687 ◽  
Author(s):  
F. Tarantini ◽  
S. Fumagalli ◽  
L. Boncinelli ◽  
M. C. Cavallini ◽  
E. Mossello ◽  
...  
Keyword(s):  
Case Report ◽  
Adrenal Insufficiency ◽  
Severe Hyponatremia

scholarly journals A Case Report on Hyponatremia: Leading Sign of Hypopituitarism [Secondary to Adrenal Insufficiency]

2020 ◽  
Vol 5 (8) ◽  
pp. 57-60
Author(s):  
Dr. Poornima . ◽  
Dr. Arul Amutha Elizabeth
Keyword(s):  
Case Report ◽  
Adrenal Insufficiency ◽  
Severe Hyponatremia ◽  
Altered Sensorium ◽  
Life Threatening ◽  
Underlying Disorder ◽  
Made In

Severe hyponatremia due to hypopituitarism and adrenal insufficiency can be life threatening and treatment with glucocorticoids is very effective once the diagnosis of the underlying disorder has been made. In our experience, the diagnosis of hypopituitarism in hyponatremic patients is often overlooked. We report the case of a 54 year old female admitted to our hospital in an obtunded state with altered sensorium. We found that a severe hyponatremia was the cause of patient condition . Previously she was diagnosed with recurrent episodes of hyponatremia leading to encephalopathy. The diagnosis of hypopituitarism is often overlooked in hyponatremic patients. Hyponatremia should always be ruled out for endocrinological cause Our study concludes that hyponatremia is due to hypopituitarism that is secondary to adrenal insufficiency leading to encephalopathy.

scholarly journals Primary adrenal insufficiency due to bilateral adrenal infarction in COVID-19: a case report

2021 ◽  
Author(s):  
Iza F R Machado ◽  
Isabel Q Menezes ◽  
Sabrina R Figueiredo ◽  
Fernando Morbeck Almeida Coelho ◽  
Debora R B Terrabuio ◽  
...  
Keyword(s):  
Case Report ◽  
Adrenal Insufficiency ◽  
Antiphospholipid Syndrome ◽  
Antiphospholipid Antibodies ◽  
Case Reports ◽  
Serum Cortisol ◽  
Primary Adrenal Insufficiency ◽  
Acute Adrenal Insufficiency ◽  
Adrenal Infarction ◽  
New Onset

Abstract Context Coronavirus disease 2019 (COVID-19) is a proinflammatory and prothrombotic condition, but its impact on adrenal function has not been adequately evaluated. Case report A 46-year-old woman presented with abdominal pain, hypotension, skin hyperpigmentation after COVID-19 infection. The patient had hyponatremia, serum cortisol <1.0 ug/dL, ACTH of 807 pg/mL and aldosterone <3 ng/dL. Computed tomography (CT) findings of adrenal enlargement with no parenchymal and minimal peripheral capsular enhancement after contrast were consistent with bilateral adrenal infarction. The patient had autoimmune hepatitis and positive antiphospholipid antibodies, but no previous thrombotic events. The patient was treated with intravenous hydrocortisone, followed by oral hydrocortisone and fludrocortisone. Discussion Among 115 articles, we identified nine articles, including case reports, of new-onset adrenal insufficiency and/or adrenal hemorrhage/infarction on CT in COVID-19. Adrenal insufficiency was hormonally diagnosed in five cases, but ACTH levels were measured in only three cases (high in one case and normal/low in other two cases). Bilateral adrenal non- or hemorrhagic infarction was identified in five reports (two had adrenal insufficiency, two had normal cortisol levels and one case had no data). Interestingly, the only case with well-characterized new-onset acute primary adrenal insufficiency after COVID-19 had a previous diagnosis of antiphospholipid syndrome. In our case, antiphospholipid syndrome diagnosis was established only after the adrenal infarction triggered by COVID-19. Conclusions Our findings support the association between bilateral adrenal infarction and antiphospholipid syndrome triggered by COVID-19. Therefore, patients with positive antiphospholipid antibodies should be closely monitored for symptoms or signs of acute adrenal insufficiency during COVID-19.

Sign in / Sign up

Export Citation Format

Share Document