Non-Classic Congenital Adrenal Hyperplasia due to 21-Hydroxylase Deficiency that Developed into Symptomatic Severe Hyponatremia

Sawako Goto, Susumu Ookawara, Kaoru Takase, Mizue Goto, Takahiro Nakayama, Yuhta Oyama, Kaoru Tabei
2015 Internal medicine (Tokyo. 1992)  
A 78-year-old woman diagnosed with non-classic congenital adrenal hyperplasia due to 21-hydroxylase deficiency had been under glucocorticoid replacement therapy since the age of 17 years. After several weeks of suffering from gastroenteritis with vomiting, she presented with disturbance of consciousness, hypotension, dehydration, and severe hyponatremia (108 mEq/L) and a markedly increased serum vasopressin concentration (45.5 pg/mL). She regained consciousness after correcting her body-fluid
more » ... lance with hypertonic saline and intravenous hydrocortisone sodium therapy. Her hyponatremia was likely caused by extra-renal sodium loss and impaired water excretion induced by an increase of serum vasopressin due to volume depletion and glucocorticoid deficiency. A 78-year-old woman living alone had developed gastroenteritis with nausea and vomiting and had not been able to consume any food for approximately 2 weeks. Although she was diagnosed with non-classic congenital adrenal hyperpla-
doi:10.2169/internalmedicine.54.3901 pmid:25986269 fatcat:4ngukwfrqzg5nb5uingj4uhi24