Turkish Journal of
GERIATRICS

Pondicherry Institute of Medical Sciences Internal Medicine Pondicherry/India We report an 87 year old man who was admitted for an open reduction of a left hip dislocation. A month earlier, he had been admitted for a right-sided hemiarthroplasty to treat a fracture of the neck of femur, and had hyponatremia documented during his hospital stay. Evaluation of postoperative hyponatremia during his present admission revealed bilateral pleural effusion, elevated thyroid stimulating hormone levels and a urinary tract infection. His sodium levels had initially improved with oral L-thyroxine, but an adrenal insufficiency was unmasked two days after therapy; his condition was also complicated by respiratory failure, hypotension and altered sensorium. He was managed with mechanical ventilation, L-thyroxine, hydrocortisone, inotropes and antibiotics. His sodium remained normal thereafter until time of his discharge. Keywords : Hypothyroidism; Hyponatremia; Aged; Myxedema