Evaluation of thyroid and adrenal functions in patients with hyponatremia

Hyponatremia is frequently detected as a cause in patients admitted to command Hospital Kolkata with altered sensorium. We evaluated these patients to rule out two common endocrine causes as etiological factors i.e. hypothyroidism and hypoadrenalism.

We studied 100 patients over a period of two years in all seasons who were admitted to hospital with altered sensorium and found to have hyponatremia as a cause, after ruling out other causes of altered sensorium as per inclusion and exclusion criteria. They were subjected to thyroid and adrenal evaluation in addition to detailed history, clinical examination and lab evaluation as per study protocol.

Total 100 patients were enrolled in the study. The age of patients varied from 31 years to more than 70 years. Majority of patients were between the age group of 41-60 years (49 patients. Males were predominant in the study. Only 8 patients were detected to have hypothyroidism requiring replacement therapy and only 2 patients had adrenal insufficiency. 48 patients had drug induced hyponatremia and 42 idiopathic hyponatremia. No seasonal variation was noted.

Thiazide diuretic intake as antihypertensive drug was found to be a major cause of hyponatremia. Most of the patients in this group were using thiazide diuretics. In idiopathic group the cause of hyponatremia can be hypothesized as multifactorial. The hot and humid climate of Kolkata and other coastal regions made them more vulnerable to develop hyponatremia. Hypothyroidism and hypoadrenalism were not found to be major causes of unexplained hyponatremia.