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Hyponatremia and seizures caused by triamcinolone-induced adrenal insufficiency

Nature Reviews Nephrology volume 6, pages 117–123 (2010)Cite this article

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A Correction to this article was published on 01 June 2010

Abstract

Background. A 49-year-old woman presented to hospital with an 18-month history of hyponatremic episodes, nausea, vomiting, anorexia and fatigue.

Investigations. Physical examination, laboratory tests including full blood count, measurement of electrolytes, hormones, autoantibodies, thyroid and renal function, corticotropin-releasing-hormone stimulation test, 24 h urinalysis and abdominal ultrasonography.

Diagnosis. Severe symptomatic hyponatremia in a patient with secondary adrenal insufficiency caused by treatment of lumbago with triamcinolone injections.

Management. Hydrocortisone replacement therapy (15 mg daily) for 3 months, followed by a tapering schedule over 12–24 months.

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Figure 1: Hormonal interactions that regulate the hypothalamic–pituitary–adrenal axis.

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Authors and Affiliations

  1. University of Münster, Medizinische Klinik und Poliklinik D, Albert-Schweitzer Strasse 33, 48149, Münster, Germany

    Stefan Reuter, Niklas Scholten, Hermann Pavenstädt, Uta Hillebrand & Eckhart Büssemaker

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Correspondence to Stefan Reuter.

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Reuter, S., Scholten, N., Pavenstädt, H. et al. Hyponatremia and seizures caused by triamcinolone-induced adrenal insufficiency. Nat Rev Nephrol 6, 117–123 (2010). https://doi.org/10.1038/nrneph.2009.215

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