Schmidt’S Syndrome and Severe Hyponatremia: Report of an Unusual Case and Review of the Related Literature

Gumieniak, Olga; Farwell, Alan P.

doi:10.4158/ep.9.5.384

Cited by 9 publications

(9 citation statements)

References 27 publications

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“…Our patient was different from the other reported cases [2][3][4][5][6][7][8][9][10][11]. The TSH level and the baseline cortisol level were normal.…”

Section: Discussioncontrasting

confidence: 80%

“…Interestingly, nausea, vomiting and diarrhea were constant findings in all reported cases. Gumieniak [2] concluded that Schmidt's syndrome manifesting concomitantly with Addison's disease and primary hypothyroidism leads to a greater degree of hyponatremia than would occur for any of these diseases alone or for them manifesting sequentially. Severe hyponatremia seems to occur more often in patients with greater TSH elevation.…”

Section: Discussionmentioning

confidence: 97%

“…The adrenal insufficiency was diagnosed three years after the diagnosis of hypothyroidism. This raises the question of whether the conclusions of Gumieniak [2] and Siewert [11] are still valid for explaining the severe hyponatremia. There is no doubt that profound hyponatremia was found in patients with severe hypothyroidism, but other factors leading to ADH release, such as nausea, vomiting, diarrhea and dehydration should be also considered as major contributors to the severe hyponatremia.…”

Section: Discussionmentioning

confidence: 99%

“…It is related to adrenal failure and hypothyroidism. On the other hand, severe hyponatremia is a rare finding and has been reported only in case reports [2].…”

Section: Introductionmentioning

confidence: 98%

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Severe hyponatremia and Schmidt’s syndrome

Wehbe

Grant

2008

Clin Exp Nephrol

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Severe hyponatremia, defined by a sodium concentration of below 115 meq/l, is rarely reported with Schmidt's syndrome. We report a 43-year-old woman diagnosed with Schmidt's syndrome during the workup for severe hyponatremia as well a review of all the reported cases. The Medline database from 1960 to 2007 and relevant references of selected articles were searched. Search terms included hyponatremia, hypothyroidism, autoimmune thyroid disease, adrenal insufficiency, adrenal failure, Schmidt's syndrome and autoimmune polyendocrine syndrome type 2. The search was restricted to the English language, human subjects, and patients with a serum sodium concentration of below 115 meq/l. Seven cases were reported including this report. Severe hyponatremia seems to be found more often in patients with severe hypothyroidism. To our knowledge this is the first case to describe the occurrence of severe hyponatremia with normal thyroid function test and normal baseline cortisol level.

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“…Our patient was different from the other reported cases [2][3][4][5][6][7][8][9][10][11]. The TSH level and the baseline cortisol level were normal.…”

Section: Discussioncontrasting

confidence: 80%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

“…It is related to adrenal failure and hypothyroidism. On the other hand, severe hyponatremia is a rare finding and has been reported only in case reports [2].…”

Section: Introductionmentioning

confidence: 98%

See 2 more Smart Citations

Severe hyponatremia and Schmidt’s syndrome

Wehbe

Grant

2008

Clin Exp Nephrol

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“…9 Furthermore, in some patients with AD with thyroid autoantibodies and thyrotropin levels below 30 mcU/mL, thyrotropin levels may normalize after glucocorticoid replacement. 5,28 If this does not occur and persistent elevation of thyrotropin levels remain, titration of levothyroxine should be based on degree of thyroid dysfunction as noted with changes in laboratory values over time. 29 Other components of autoimmunity must be treated according to their typical therapies.…”

Section: Treatment Of Apsmentioning

confidence: 99%