Logo American Journal of Case Reports

Call: 1.631.629.4328
Mon-Fri 10 am - 2 pm EST

Contact Us

Logo American Journal of Case Reports Logo American Journal of Case Reports Logo American Journal of Case Reports

25 September 2009

Hyponatremia following administration of losartan, an angiotensin II receptor blocker, in a patient with isolated ACTH deficiency

Naoki Hiroi, Aya Yoshihara, Mariko Sue, Takamasa Ichijo, Ryo Iga, Rika Shigemitsu, Natsumi Masai, Gen Yoshino

Am J Case Rep 2009; 10:141-144 :: ID: 878192


Background: Hyperpotassemia is a common side effect of inhibitors of the renin–angiotensin–aldosterone system, however hyponatremia is rarely seen. Herein, we report on the fi rst case of hyponatremia attributable to angiotensin II receptor blocker (ARB) therapy with isolated ACTH defi ciency.
Case Report: A 68-year-old man with vertigo, nausea, loss of appetite and weight loss presented to our hospital because of hyponatremia after administration of 25 mg losartan daily for 2 weeks. Three weeks after withdrawal of losartan, serum Na concentrations improved. An endocrinological examination showed low plasma adrenocorticotropic hormone (ACTH) and cortisol concentrations (11.1 pg/mL and 1.4 μg/mL, respectively), as well as low levels of urinary free cortisol. Plasma levels of ACTH and cortisol did not increase after the administration of corticotropin-releasing hormone and a blunted cortisol response was observed to rapid ACTH stimulation. There were no other abnormalities in pituitary hormones. On the basis of these results, diagnoses of chronic adrenal insufficiency due to isolated ACTH defi ciency and hyponatremia caused by losartan were made.
Conclusions: Although ARBs are useful antihypertensive drugs, their administration may cause both hyperpotassemia and hyponatremia.

Keywords: Hyponatremia, Angiotensin II receptor 1 blockers, isolated ACTH deficiency

Add Comment 0 Comments

In Press

01 Mar 2024 : Case report  USA

Complicated Treatment Course of Severe Asymptomatic Hypertriglyceridemia: A Case Report and Literature Review

Am J Case Rep In Press; DOI: 10.12659/AJCR.943858  

04 Mar 2024 : Case report  Switzerland

Unintentional Plastic Blister Ingestion Leading to Intestinal Perforation: A Report of Two Cases

Am J Case Rep In Press; DOI: 10.12659/AJCR.943514  

04 Mar 2024 : Case report  Belgium

Nivolumab-Induced Cytokine Release Syndrome: A Case Report and Literature Review

Am J Case Rep In Press; DOI: 10.12659/AJCR.941835  

05 Mar 2024 : Case report  USA

Intrapulmonary Shunting and Paradoxical Air Embolism in Liver Transplantation: A Case Report

Am J Case Rep In Press; DOI: 10.12659/AJCR.943042  

Most Viewed Current Articles

07 Mar 2024 : Case report  USA

Neurocysticercosis Presenting as Migraine in the United States

DOI :10.12659/AJCR.943133

Am J Case Rep 2024; 25:e943133


10 Jan 2022 : Case report  Germany

A Report on the First 7 Sequential Patients Treated Within the C-Reactive Protein Apheresis in COVID (CACOV...

DOI :10.12659/AJCR.935263

Am J Case Rep 2022; 23:e935263

19 Jul 2022 : Case report  Saudi Arabia

Atlantoaxial Subluxation Secondary to SARS-CoV-2 Infection: A Rare Orthopedic Complication from COVID-19

DOI :10.12659/AJCR.936128

Am J Case Rep 2022; 23:e936128

23 Feb 2022 : Case report  USA

Penile Necrosis Associated with Local Intravenous Injection of Cocaine

DOI :10.12659/AJCR.935250

Am J Case Rep 2022; 23:e935250

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923