Hyponatremia with Increased Plasma Antidiuretic Hormone in a Case of Hypothyroidism.

Abstract

Wereport a 70-year-old womanwith 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 ADHlevel played an important role in the development of hyponatremia in this case.

Current issues for nurse practitioners: Hyponatremia

“…Hypothyroidism is commonly associated with hyponatremia (Baajafer, Hammami, & Mohamed, 1999; Nakano, Higa, Ishikawa, Yamazaki, & Yamamuro, 2000). Although SIADH has been associated in the literature with hypothyroidism, the underlying mechanisms are unknown.…”

“…An attending neurologist reported admitting a 70‐year‐old woman to the hospital for evaluation of an altered level of consciousness and convulsions (Nakano et al, 2000). She gave a history of fatigue and sleepiness without nausea for 6 months and a 27‐year history of hypertension, for which she currently takes angiotensin‐converting enzyme inhibitors.…”

New agents for managing hyponatremia in hospitalized patients

“…51 Endocrine disorders. Endocrine disorders that are associated with hyponatremia include hypothyroidism 52,53 and adrenal insufficiency. 54 Hyponatremia has also been reported in 38% of patients hospitalized with acquired immunodeficiency syndrome (AIDS) or AIDS-related complex, either as a result of gastrointestinal fluid loss or SIADH, 55 and is associated with an increased duration of hospitalization and a decreased likelihood of survival in patients with human immunodeficiency virus (HIV) infection.…”

Hipotiroidizmde Ödem Mekanizmaları

“…Serbest su fazlalığının nedeninin uygunsuz ADH salınımı olduğu iddia edilmiştir (1,10,11). Hipotiroidizmde kardiyak debinin düşmesinin karotis sinüsdeki baroreseptörleri stimüle ederek ADH salınıma neden olduğu bildirilmiştir (12).…”