title: Non-Classic Congenital Adrenal Hyperplasia due to 21-Hydroxylase Deficiency that Developed into Symptomatic Severe Hyponatremia.
abstract: A 78-year-old woman diagnosed with non-classic congenital adrenal hyperplasia due to 21-hydroxylase deficiency had been under glucocorticoid replacement therapy since the age of 17 years. After several weeks of suffering from gastroenteritis with vomiting, she presented with disturbance of consciousness, hypotension, dehydration, and severe hyponatremia (108 mEq/L) and a markedly increased serum vasopressin concentration (45.5 pg/mL). She regained consciousness after correcting her body-fluid balance with hypertonic saline and intravenous hydrocortisone sodium therapy. Her hyponatremia was likely caused by extra-renal sodium loss and impaired water excretion induced by an increase of serum vasopressin due to volume depletion and glucocorticoid deficiency.
authors.affiliation: Division of Nephrology, The First Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, 2. Division of  Internal Medicine, Nihonkai General Hospital, Japan.
authors.forename: Sawako
authors.initials: S
authors.lastname: Goto
authors.forename: Susumu
authors.initials: S
authors.lastname: Ookawara
authors.forename: Kaoru
authors.initials: K
authors.lastname: Takase
authors.forename: Mizue
authors.initials: M
authors.lastname: Goto
authors.forename: Takahiro
authors.initials: T
authors.lastname: Nakayama
authors.forename: Yuhta
authors.initials: Y
authors.lastname: Oyama
authors.forename: Kaoru
authors.initials: K
authors.lastname: Tabei
mesh_terms: D000312:Adrenal Hyperplasia, Congenital / Q000150:complications*; D000309:Adrenal Insufficiency / Q000209:etiology; D000368:Aged; D005260:Female; D005938:Glucocorticoids / Q000097:blood; D006801:Humans; D007010:Hyponatremia / Q000209:etiology* / Q000628:therapy; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage; D012964:Sodium; D014667:Vasopressins / Q000097:blood
chemical_list: D005938:Glucocorticoids; D012462:Saline Solution, Hypertonic; D014667:Vasopressins; D012964:Sodium