Hyponatremia as the presenting manifestation of Sheehan’s syndrome in elderly patients

Kurtulmuş, Neslihan; Yarman, Sema

doi:10.1007/bf03324855

Cited by 12 publications

(5 citation statements)

References 24 publications

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“…Syndrome of inappropriate antidiuretic hormone secretion (SIADH) and volume depletion can also lead to hyponatremia. Volume depletion, cortisol deficiency and hypothyroidism are the causative factors for hypo- Case report natraemia in our patient and this was easily corrected with salt replacement with hydrocortisone and thyroxine treatment (10)(11)(12)(13).…”

Section: Discussionmentioning

confidence: 88%

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Seizures: a rare presentation of Sheehan’s syndrome

Cooray¹,

Bulugahapitiya²,

Ranasinghe

2014

Sri Lanka J. Diabetes Endocrinol. Metab.

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Sheehan's syndrome is a well-known cause of panhypopituitarism following ischemic damage to the pituitary gland or stalk during peripartum period. Degree of hypopituitarism in Sheehan's syndrome can vary and due to the slow evolution, the diagnosis can be delayed. Here we report a case presented to us with hyponatremia, 2 years after her complicated delivery, which highlights the importance of recognizing hyponatremia as a presentation of hypopituitarism in Sheehan's syndrome.

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Section: Discussionmentioning

confidence: 88%

“…Hyponatremia is not a disease, but a manifestation of a variety of disorders and it may be the only manifestation of hypopituitarism or hypothyroidism. The diagnosis of hypopituitarism in hyponatraemic patients is often overlooked and it is a common electrolytic disorder, occurring in 33% to 69% of all cases with Sheehan's syndrome (10).…”

Section: Discussionmentioning

confidence: 99%

Seizures: a rare presentation of Sheehan’s syndrome

Cooray¹,

Bulugahapitiya²,

Ranasinghe

2014

Sri Lanka J. Diabetes Endocrinol. Metab.

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“…The presence of recurrent hyponatraemia made our suspicion stronger as did the history of lactational failure. Hyponatraemia and hypoglycaemia have been reported as presentations of hypopitutarism8 , 9 in older patients that, if ignored or not diagnosed in time, can prove fatal. Hypoglycaemia is another fatal presentation of hypopitutarism and Sheehan’s syndrome and was reported in 44% cases in one study 10.…”

Section: Discussionmentioning

confidence: 99%

Practice of symptomatic treatment in the era of evidence-based medicine: report of 2 cases of diagnosis of Sheehan's syndrome delayed till eighth decade

Wani

Hussain²,

Mejally³

et al. 2010

Case Reports

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Sheehan's syndrome, first described in 1937, is characterised by postpartum haemorrhage, pituitary necrosis, lactational failure and hypopitutarism. Presentation is variable and late presentations are not unusual due to partial ischaemic injury of the pituitary and gradual loss of endocrine function. A history of postpartum haemorrhage is usual but in some cases it is not elicited. Presentations such as malaise, fatigue, hypoglycaemia, decline in cognition, hyponatraemia, pancytopoenia, osteoporosis, secondary infertility, confusion and coma have all been reported. Two interesting cases of Sheehan's syndrome are presented that were diagnosed in the eighth decade; one due to atypical presentation of recurrent hyponatraemia and confusion, another from hypoglycaemic coma and symptoms of malaise and lethargy.

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“…ADH is released in response to effective volume depletion; consequently when hypothyroidism is encountered in the setting of complete pituitary failure there is often hyponatremia 2, 3. Alternatively, with myxedema, the ability of the kidney to handle a water load and concentrate urine can be impaired 4…”

Section: Hypothyroidism and Hyponatremiamentioning

confidence: 99%

Four nephrology myths debunked

Rachoin

Cerceo

2010

Journal of Hospital Medicine

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There are many controversial topics relating to renal disease in hospitalized patients. The aim of this review is to shed light on some important and often debated issues. Hypothyroidism, unlike myxedema, is not a cause of hyponatremia (although it can be sometimes seen in conjunction with the latter) and additional investigations should be done to determine its etiology. Sodium bicarbonate is effective for treatment of hyperkalemia primarily by enhancing renal potassium elimination rather than by translocating potassium into cells. Acetaminophen can be a cause of metabolic acidosis by causing 5‐oxoprolinuria. Furosemide (and sulfa containing diuretics) can safely be used in patients with an allergy to sulfa‐containing antibiotics (SCA). Journal of Hospital Medicine 2010;. © 2010 Society of Hospital Medicine.

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Hyponatremia as the presenting manifestation of Sheehan’s syndrome in elderly patients

Cited by 12 publications

References 24 publications

Seizures: a rare presentation of Sheehan’s syndrome

Seizures: a rare presentation of Sheehan’s syndrome

Practice of symptomatic treatment in the era of evidence-based medicine: report of 2 cases of diagnosis of Sheehan's syndrome delayed till eighth decade

Four nephrology myths debunked

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