Clinician's attention must focus on the underlying cause of AI which in this case was hidden in a miscommunication between hypothalamus and pituitary due to an ectopic posterior pituitary lobe and became apparent by a pituitary magnetic resonance imaging (MRI) scan. Following the diagnostic algorithm of hyponatremia we reached the diagnosis of AI.
We report the case of an 82-year-old patient who was admitted to our hospital with clinical symptoms and laboratory findings of hyponatremia. Hyponatremia may be one of the clinical manifestations of adrenal insufficiency (AI) and during the diagnostic workup of hyponatremic patients investigation of AI should be included. Received in revised form January 11, 2016 This is an open access article distributed under the Creative Commons Attribution-NoDerivatives License 4.0, which allows for redistribution, commercial and non-commercial, as long as it is passed along unchanged and in whole, with credit to the author.
The authors have no conflicts of interest to disclose. Informed consent was given by the patient. Kiriakidi 1, 54636 Thessaloniki, Greece (e-mail: ).Ībbreviations: ACTH = adrenocorticotropic hormone, ADH = antidiuretic hormone, AI = adrenal insufficiency, CRH = corticotropin-releasing hormone, eGFR = estimated glomerular filtration rate, MRI = magnetic resonance imaging, SIADH = syndrome of inappropriate secretion of antidiuretic hormone From the Department of Endocrinology and Metabolism – Diabetes Center, 1st Clinic of Internal Medicine (MG, ER, ACM, MY, SK, JY, KK) and 1st Department of Internal Medicine, AHEPA University Hospital, Thessaloniki, Greece (AT, MD).Ĭorrespondence: Kalliopi Kotsa, Division of Metabolism and Endocrinology, 1st Department of Internal Medicine, AHEPA University Hospital, S.
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