Can a Diagnosis be Ruled Out Based on One Cortisol Result? A Case Report on Delayed Diagnosis of Hypopituitarism

James P, Gupta P and Patel P

Abstract

There are numerous potential causes for hyponatraemia including hypovolaemia; oedema; syndrome of inappropriate ADH secretion; and acute episodes of Addison’s disease (hypopituitarism and adrenal insufficiency) [1]. Hyponatraemia can have serious consequences for patients and there are many ways to investigate the cause. Here we present a case of an elderly patient presenting with hyponatraemia and highlight the limitations of the standard dose (250 mcg) short synacthen test (SST) for the investigation of adrenal insufficiency as a potential cause of hyponatraemia.