Hyponatremia and seizures caused by triamcinolone-induced adrenal insufficiency.

BACKGROUND

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

METHODS

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.

METHODS

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

RESULTS

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