Hyponatremia with increased plasma antidiuretic hormone in a case of hypothyroidism.
We report a 70-year-old woman with hypothyroidism and severe hyponatremia. Her plasma antidiuretic hormone (ADH) level was inappropriately high for her low plasma osmolality. Her low serum sodium level was gradually corrected by water restriction and sodium supplementation prior to the initiation of thyroid hormone replacement. After a diagnosis of Hashimoto's thyroiditis had been made, the patient was treated with levothyroxine. Following this treatment, the patient's serum sodium level increased drastically. It is suggested that the elevated plasma ADH level played an important role in the development of hyponatremia in this case.
Nakano
M
M
Department of Internal Medicine, Saiseikai Kanagawaken Hospital, Yokohama.
Higa
M
M
Ishikawa
R
R
Yamazaki
T
T
Yamamuro
W
W
D000311:Adrenal Glands / Q000378:metabolism / Q000473:pathology; D000324:Adrenocorticotropic Hormone; D000368:Aged; D001323:Autoantibodies / Q000097:blood; D001327:Autoimmune Diseases / Q000097:blood / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D001834:Body Water / Q000378:metabolism; D003346:Corticotropin-Releasing Hormone; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use; D006984:Hypertrophy; D007010:Hyponatremia / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology; D018828:Immunoglobulins, Thyroid-Stimulating; D007177:Inappropriate ADH Syndrome / Q000209:etiology* / Q000503:physiopathology; D009318:Natriuresis; D011989:Receptors, Thyrotropin / Q000097:blood; D012079:Renal Circulation; D012964:Sodium; D013967:Thyroiditis, Autoimmune / Q000097:blood / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D013973:Thyrotropin-Releasing Hormone; D013974:Thyroxine / Q000627:therapeutic use; D014883:Water-Electrolyte Imbalance / Q000209:etiology / Q000503:physiopathology
D001323:Autoantibodies; D018828:Immunoglobulins, Thyroid-Stimulating; D011989:Receptors, Thyrotropin; C056626:thyroid microsomal antibodies; C094372:thyrotropin-binding inhibitory immunoglobulin; D013973:Thyrotropin-Releasing Hormone; D000324:Adrenocorticotropic Hormone; D003346:Corticotropin-Releasing Hormone; D012964:Sodium; D013974:Thyroxine; D006854:Hydrocortisone