Potential Mechanisms of Hypothyroidism-induced Hyponatremia

Kimura, Tokihisa

doi:10.2169/internalmedicine.39.1002

Cited by 12 publications

(11 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Therefore, we believe that adrenal insufficiency was the main cause of the hyponatremia and rhabdomyolysis. However, an association between hypothyroidism and severe hyponatremia is also known, mainly due to an increased release of anti-diuretic hormone (ADH) caused by a reduced sensitivity of the osmoreceptors to reductions in plasma osmolality [12]. …”

Section: Discussionmentioning

confidence: 99%

Late-onset Sheehan’s syndrome presenting with rhabdomyolysis and hyponatremia: a case report

et al. 2013

View full text Add to dashboard Cite

IntroductionHyponatremia associated with rhabdomyolysis is a rare event and a correct diagnostic approach is required to rule out this or other diseases as a primary cause and to avoid other complications resulting from a lack of appropriate treatment.Case presentationA 64-year-old Caucasian woman presented to our facility with worsening fatigue, slurred speech, nausea and vomiting, and high serum levels of creatine kinase and myoglobin together with hyponatremia. Normal arterial blood gas analysis results, normal serum potassium levels, increased urine sodium levels, urine specific gravity of >1003N/m3 and low urine volume suggested an endocrine etiology. Her low cortisol and thyroid hormone serum levels suggested a pituitary disorder. A magnetic resonance imaging study showed atrophy of her pituitary gland. A more detailed study of our patient’s obstetric history revealed a post-partum hemorrhage 30 years earlier. She was diagnosed as having late-onset Sheehan’s syndrome and treated with hormone replacement therapy, which normalized her clinical picture.ConclusionsThis case report shows that, in hyponatremia-associated rhabdomyolysis, an endocrinological origin should always be considered. This should include Sheehan’s syndrome as it can occur with late onset.

show abstract

Section: Discussionmentioning

confidence: 99%

Late-onset Sheehan’s syndrome presenting with rhabdomyolysis and hyponatremia: a case report

et al. 2013

View full text Add to dashboard Cite

show abstract

“…Additionally, psychosis due to hypothyroidism is reversible and can be easily treated (Hanna and Scanlon, 1997). Patients with neuropsychiatric symptoms and presenting with hyponatremia should have careful assessment of their thyroid status as it is assumed that over secretion of ADH and renal hypofunction in hypothyroidism may lead to hyponatremia (Kimura, 2000).…”

Section: Discussionmentioning

confidence: 99%

“…The psychiatric symptoms vary and the patient is first diagnosed with primary psychiatry disturbance rather than hypothyroidism (Pomeranze and King, 1966). Although the temporal association between hypothyroidism and hyponatremia are well documented and many investigations on the potential mechanisms have been carried out, the cause of this association is not well understood (Kimura, 2000). Patients with hypothyroidism have a diminished ability to excrete free water (Schrier, 2006;Derubertis et al, 1971, Hanna andScanlon, 1997) …”

Section: Introductionmentioning

confidence: 99%

Hypothyroidism Induced Myxedema Madness and Hyponatremia: A Case Report

Gopinathan¹,

James²

2017

J App Pharma Sci

View full text Add to dashboard Cite

Hypothyroidism is a frequently encountered medical condition in general population. Several disorders can arise when the thyroid hormone production is either too high or not enough. We report here about a hypothyroid patient who was presented to a tertiary hospital with psychotic manifestations. A 55 year old male with family history of psychosis in first degree relative had for the past 2 months reduced sleep at night, reduced appetite and less interaction with family members and gradually developed trouble in speaking. Registration of memory was impaired, features of delusions of persecution and reference and third person auditory hallucinations were present. Patient was started on antipsychotics for one week but without any improvement. Laboratory investigations demonstrated hyponatraemia and an abnormal thyroid profile: thyroid stimulating horm one: 10.89 uIU/ml, free triiodo threonine (FT3): 1.96 pg/ml and a normal thyroid on ultrasound. Tab levothyroxine 125 mcg was added along with the antipsychotics. The patient showed marked improvement in symptoms and the antipsychotics were withdrawn over a week. Thereafter there were no signs or symptoms of delusions or hallucinations and the patient was discharged on tab levothyroxine alone. Thyroxine supplementation also resolved the hyponataremia in this patient.

show abstract

“…The third hypothesis is that decreased synthesis and secretion of atrial natriuretic peptide which leads to decreased serum atrial natriuretic peptide concentration and subsequently to a decreased glomerular filtration rate and renal plasma flow contributes to decreased water excretion. Consequently, water retention caused by oversecretion of antidiuretic hormone and renal insufficiency from hypothyroidism can induce hyponatremia [12]. …”

Section: Discussionmentioning

confidence: 99%

Hyponatremia after Thyroid Hormone Withdrawal in a Patient with Papillary Thyroid Carcinoma

Kim

Shin

et al. 2014

Endocrinol Metab

View full text Add to dashboard Cite

Hyponatremia is an electrolyte abnormality commonly found in clinical practice. It is important to diagnose the underlying etiology of the hyponatremia and correct it appropriately because severe hyponatremia can cause serious complications and substantially increase the risk of mortality. Although hypothyroidism is known to be a cause of hyponatremia, it is rare that hyponatremia occurs in relation to hypothyroidism induced by thyroid hormone withdrawal in patients with differentiated thyroid cancer. We report a case of a 76-year-old woman with papillary thyroid carcinoma presenting with severe hyponatremia related to hypothyroidism induced by thyroid hormone withdrawal for radio-active iodine whole-body scanning, who was treated by thyroid hormone replacement and hydration. Considering that the incidence of differentiated thyroid cancer is rapidly increasing, physicians should be aware that, although uncommon, hyponatremia can occur in patients undergoing radioiodine therapy or diagnostic testing.

show abstract

Potential Mechanisms of Hypothyroidism-induced Hyponatremia

Cited by 12 publications

References 10 publications

Late-onset Sheehan’s syndrome presenting with rhabdomyolysis and hyponatremia: a case report

Late-onset Sheehan’s syndrome presenting with rhabdomyolysis and hyponatremia: a case report

Hypothyroidism Induced Myxedema Madness and Hyponatremia: A Case Report

Hyponatremia after Thyroid Hormone Withdrawal in a Patient with Papillary Thyroid Carcinoma

Contact Info

Product

Resources

About