Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc
Journal website http://www.jocmr.org

Case Report

Volume 7, Number 4, April 2015, pages 286-288

Secondary Adrenal Insufficiency: An Overlooked Cause of Hyponatremia

Figure

Figure 1.
Figure 1. Hypo-enhancing focus within the right anterior sella consistent with pituitary microadenoma.

Tables

Table 1. Initial Serum and Urine Electrolytes
 
SerumUrine
Osmolality273 mOsm/kg614 mOsm/kg
Sodium129 mmol/L106 mmol/L
Potassium4 mmol/L57 mmol/L
Chloride98 mmol/L91 mmol/L
Bicarbonate22 mmol/L
Albumin3.1 g/dL

 

Table 2. Cosyntropin Stimulation Test
 
TestBaseline30 min60 min
ACTH< 1.1 pg/mL
Cortisol7.1 μg/dL9.90 μg/dL12.30 μg/dL
Aldosterone1.20 ng/dL

 

Table 3. Hormone Assays
 
HormoneLevelNormal range
FSH11.7025.8 - 134.8 mIU/mL
LH2.107.7 - 58.5 mIU/mL
TSH0.520.27 - 4.2 mIU/mL
Free T41.400.93 - 1.7 ng/dL
Prolactin102.304.8 - 23.3 ng/mL

 

Table 4. Treatment Outcome
 
Pre-treatmentPost-treatment
Sodium129 mmol/L133 mmol/L