Exp Clin Endocrinol Diabetes 2001; Vol. 109(2): 120-123
DOI: 10.1055/s-2001-14832
Case Report

© Johann Ambrosius Barth

Fatigue and hyponatremia in a 75-year-old woman: unusual presentation of hypophysitis

J. Klein, W. Kern, H. L. Fehm
  • Department of Internal Medicine I, Medical University of Lübeck, Germany
Further Information

Publication History

Publication Date:
31 December 2001 (online)


A 75-year-old woman presented with general fatigue progressing to somnolence. Laboratory tests showed marked hyponatremia, TSH in the normal range, but low levels of free T3 and free T4. Evaluation of pituitary hormones and magnetic resonance imaging of the pituitary unmasked findings characteristic for hypophysitis with secondary adrenal insufficiency and secondary hypothyroidism. Hormonal substitution with hydrocortisone and levothyroxine resulted in rapid improvement of all symptoms and signs. Without additional treatment shrinkage of the pituitary gland could be documented. Our report extends the known clinical and pathological spectrum of hypophysitis and illustrates the need to include this uncommon entity in the differential diagnosis of hyponatremia even in elderly patients.


Dr. Johannes Klein

Department of Internal Medicine I

Ratzeburger Allee 160

D-23538 Lubeck


Phone: + 49-451-500 2867

Fax: + 49-451-500 4193

Email: johannes.klein@medinf.mu-luebeck.de