SEVERE HYPONATREMIA AND RHABDOMYOLYSIS ASSOCIATED WITH HYPOTHYROIDISM : A CASE REPORT

2016-12-30T05-45-32Z
Source: Cukurova Medical Journal
Aysun Toraman, Belda Dursun, Mehmet Batmazoğlu.
Hyponatremia is one of the laboratory feature of hypothyroidism and usually occurs in elderly patients. There was introduced a young patient with hypothyroidism induced severe hyponatremia and rhabdomyolysis. A nineteen-year-old woman was brought to the hospital with confusion. On physical examination she was sleepiness and systemic examination was normal. The laboratory parameters were as follows: sodium, 117 mmol/L; aspartate aminotransferase, 201 IU/L; alanin aminotransferase, 108 IU/L; creatine phosphokinaze, 44469 IU/L; lactate dehydrogenase ,1869 IU/L. Because of acute hyponatremia with confusion, she was treated with hypertonic saline. The neurological examination returned to normal after treatment and fluid restriction, then serum sodium level increased to normal. Because recurrent hyponatremia futher investigations were held. She was diagnosed as Hashimoto's thyroiditis. Hyponatremia improved with levothyroxine therapy and serum sodium level remained normal range. The elevated parameters of rhabdomyolysis decreased with levothyroxine therapy. Hypothyroidism should be considered in patients presenting with hyponatremia and rhabdomyolysis.


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