{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T23:12:17Z","timestamp":1782601937303,"version":"3.54.5"},"reference-count":12,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2013,10,1]],"date-time":"2013-10-01T00:00:00Z","timestamp":1380585600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Case Reports"],"published-print":{"date-parts":[[2013,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Introduction<\/jats:title>\n            <jats:p>Hyponatremia associated with rhabdomyolysis is a rare event and a correct diagnostic approach is required to rule out this or other diseases as a primary cause and to avoid other complications resulting from a lack of appropriate treatment.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Case presentation<\/jats:title>\n            <jats:p>A 64-year-old Caucasian woman presented to our facility with worsening fatigue, slurred speech, nausea and vomiting, and high serum levels of creatine kinase and myoglobin together with hyponatremia. Normal arterial blood gas analysis results, normal serum potassium levels, increased urine sodium levels, urine specific gravity of &gt;1003N\/m<jats:sup>3<\/jats:sup> and low urine volume suggested an endocrine etiology. Her low cortisol and thyroid hormone serum levels suggested a pituitary disorder. A magnetic resonance imaging study showed atrophy of her pituitary gland. A more detailed study of our patient\u2019s obstetric history revealed a post-partum hemorrhage 30 years earlier. She was diagnosed as having late-onset Sheehan\u2019s syndrome and treated with hormone replacement therapy, which normalized her clinical picture.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>This case report shows that, in hyponatremia-associated rhabdomyolysis, an endocrinological origin should always be considered. This should include Sheehan\u2019s syndrome as it can occur with late onset.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/1752-1947-7-227","type":"journal-article","created":{"date-parts":[[2013,10,1]],"date-time":"2013-10-01T14:26:56Z","timestamp":1380637616000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Late-onset Sheehan\u2019s syndrome presenting with rhabdomyolysis and hyponatremia: a case report"],"prefix":"10.1186","volume":"7","author":[{"given":"Maurizio","family":"Soresi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Brunori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Citarrella","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aurelia","family":"Banco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonino","family":"Zasa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanna","family":"Di Bella","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lydia","family":"Giannitrapani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2013,10,1]]},"reference":[{"key":"2630_CR1","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1007\/s10157-007-0494-3","volume":"11","author":"M Sasaki","year":"2007","unstructured":"Sasaki M, Yuzawa M, Saito T, Ikoma A, Tamemoto H, Kawakami M, Ishikawa : Clinical and laboratory features of hyponatremia-induced myopathy. Clin Exp Nephrol. 2007, 11: 283-286. 10.1007\/s10157-007-0494-3.","journal-title":"Clin Exp Nephrol"},{"key":"2630_CR2","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1186\/cc2978","volume":"9","author":"AL Huerta-Alard\u00edn","year":"2005","unstructured":"Huerta-Alard\u00edn AL, Varon J, Marik PE: Bench-to-bedside review: rhabdomyolysis - an overview for clinicians. Crit Care. 2005, 9: 158-169. 10.1186\/cc3221.","journal-title":"Crit Care"},{"key":"2630_CR3","first-page":"1056","volume":"166","author":"HJ Milionis","year":"2002","unstructured":"Milionis HJ, Liamis GL, Elisaf MS: The hyponatremic patient: a systematic approach to laboratory diagnosis. CMAJ. 2002, 166: 1056-1062.","journal-title":"CMAJ"},{"issue":"Suppl 1","key":"2630_CR4","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1016\/j.amjmed.2007.09.001","volume":"120","author":"JG Verbalis","year":"2007","unstructured":"Verbalis JG, Goldsmith SR, Greenberg A, Schrier RW, Sterns RH: Hyponatremia treatment guidelines 2007: expert panel recommendations. Am J Med. 2007, 120 (Suppl 1): S1-S21.","journal-title":"Am J Med"},{"key":"2630_CR5","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1136\/pgmj.2005.039768","volume":"82","author":"VK Prabhakar","year":"2006","unstructured":"Prabhakar VK, Shalet SM: Aetiology, diagnosis, and management of hypopituitarism in adult life. Postgrad Med J. 2006, 82: 259-266. 10.1136\/pgmj.2005.039768.","journal-title":"Postgrad Med J"},{"key":"2630_CR6","doi-asserted-by":"publisher","first-page":"619","DOI":"10.1016\/S0140-6736(00)04060-5","volume":"357","author":"CM Dayan","year":"2001","unstructured":"Dayan CM: Interpretation of thyroid function tests. Lancet. 2001, 357: 619-624. 10.1016\/S0140-6736(00)04060-5.","journal-title":"Lancet"},{"key":"2630_CR7","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1507\/endocrj.50.297","volume":"50","author":"M Sert","year":"2003","unstructured":"Sert M, Tetiker T, Kirim S, Kocak M: Clinical report of 28 patients with Sheehan\u2019s syndrome. Endocr J. 2003, 50: 297-301. 10.1507\/endocrj.50.297.","journal-title":"Endocr J"},{"key":"2630_CR8","doi-asserted-by":"publisher","first-page":"402","DOI":"10.1097\/MAJ.0b013e3181f8c6df","volume":"340","author":"AH Tessnow","year":"2010","unstructured":"Tessnow AH, Wilson JD: The changing face of Sheehan\u2019s syndrome. Am J Med Sci. 2010, 340: 402-406. 10.1097\/MAJ.0b013e3181f8c6df.","journal-title":"Am J Med Sci"},{"key":"2630_CR9","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1023\/B:PITU.0000023425.20854.8e","volume":"6","author":"F Kele\u015ftimur","year":"2003","unstructured":"Kele\u015ftimur F: Sheehan\u2019s syndrome. Pituitary. 2003, 6: 181-188.","journal-title":"Pituitary"},{"key":"2630_CR10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1677\/JOE-09-0412","volume":"205","author":"MH Warner","year":"2010","unstructured":"Warner MH, Beckett GJ: Mechanisms behind the non-thyroidal illness syndrome: an update. J Endocrinol. 2010, 205: 1-13. 10.1677\/JOE-09-0412.","journal-title":"J Endocrinol"},{"key":"2630_CR11","doi-asserted-by":"publisher","first-page":"1059","DOI":"10.1210\/jc.2009-0032","volume":"94","author":"W Arlt","year":"2009","unstructured":"Arlt W: The approach to the adult with newly diagnosed adrenal insufficiency. J Clin Endocrinol Metab. 2009, 94: 1059-1067. 10.1210\/jc.2009-0032.","journal-title":"J Clin Endocrinol Metab"},{"key":"2630_CR12","doi-asserted-by":"publisher","first-page":"1002","DOI":"10.2169\/internalmedicine.39.1002","volume":"39","author":"T Kimura","year":"2000","unstructured":"Kimura T: Potential mechanism of hypothyroidism-induced hyponatriemia. Intern Med. 2000, 39: 1002-1003. 10.2169\/internalmedicine.39.1002.","journal-title":"Intern Med"}],"container-title":["Journal of Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/1752-1947-7-227.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/1752-1947-7-227\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/1752-1947-7-227","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/1752-1947-7-227.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,2]],"date-time":"2021-09-02T01:58:32Z","timestamp":1630547912000},"score":1,"resource":{"primary":{"URL":"https:\/\/jmedicalcasereports.biomedcentral.com\/articles\/10.1186\/1752-1947-7-227"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,10,1]]},"references-count":12,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2013,12]]}},"alternative-id":["2630"],"URL":"https:\/\/doi.org\/10.1186\/1752-1947-7-227","relation":{},"ISSN":["1752-1947"],"issn-type":[{"value":"1752-1947","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,10,1]]},"assertion":[{"value":"11 December 2012","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 June 2013","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 October 2013","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}],"article-number":"227"}}